NPIMap

Individual provider Active NPI

Johnathan W Lewis, MD

  • Family Medicine Physician
  • Camden, AR
National Provider Identifier
1699741298
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E3971 Issued in AR
Practice address
430 Magnolia Rd
Camden, AR 71701-4146
Phone
(870) 836-5709
Fax
(870) 837-2842
NPI assigned
Feb 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E3971 AR Primary

Addresses

Primary practice location

430 Magnolia Rd
Camden, AR 71701-4146

Mailing address

430 Magnolia Rd
Camden, AR 71701-4146
Phone (870) 836-4709

Other identifiers 6

IdentifierTypeStateIssuer
0000252732102OtherUNITED HEALTH CARE
771003001OtherARBREASTCARE
P00229512OtherRAILROAD MEDICARE
05030029800OtherARQUALCHOICE
154567001MedicaidAR
7165646OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040615000200 AR Practitioner - Family Practice 7214911627 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Arkansas College of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Johnathan Lewis MD PLLCGroup PAC ID 2668891763, 4 clinicians

Practice addresses (Care Compare)

2280 E Main St
El Dorado, AR 71730-6526
Phone (870) 895-2015

430 Magnolia Rd
Camden, AR 71701-4146
Phone (870) 836-4709

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions29
Removal of nail tissue1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E3971ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Access Medical Clinic Arkansas LLC Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Access Medical Clinic Arkansas LLC Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Arkansas Health Group Family Medicine CurrentSince Aug 1, 2005 Accepting new patients
Access Medical Clinic Arkansas LLC Family Medicine Current Accepting new patients
Arkansas Health Group CurrentSince Aug 1, 2005 Accepting new patients
Johnathan Lewis MD PLLC Family Medicine CurrentSince Sep 8, 2020 Accepting new patients

Locations

430 Magnolia Rd
Camden, AR 71701
Phone (870) 836-4709

353 Cash Rd SW
Camden, AR 71701
Phone (870) 836-8101

2280 E Main St
El Dorado, AR 71730
Phone (870) 444-5216

16723 Highway 62
Garfield, AR 72732
Phone (870) 219-7706

11001 Executive Center Dr
Ste 200
Little Rock, AR 72211
Phone (501) 812-7215

Interoperability endpoints

  • Direct secure messaging: johnathan.lewis.1@15024.direct.athenahealth.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Ouachita Nursing and Rehabilitation CenterCamden, AR, CCN 045207 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Sep 1, 2019
Sep 1, 2019

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1699741298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 MAGNOLIA RD",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014146",
            "telephone_number": "870-836-4709",
            "fax_number": "870-836-5837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 MAGNOLIA RD",
            "city": "CAMDEN",
            "state": "AR",
            "postal_code": "717014146",
            "telephone_number": "870-836-5709",
            "fax_number": "870-837-2842"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JOHNATHAN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E3971",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "0000252732102",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BREASTCARE",
            "identifier": "771003001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00229512",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "QUALCHOICE",
            "identifier": "05030029800",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "154567001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7165646",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, AR

Sources for this page

Verify at the official NPI Registry.