Individual provider Active NPI

Alan Paul Lewis, D.C.

  • Chiropractor
  • Jefferson, WI
National Provider Identifier
1700964228
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2506 Issued in WI
Practice address
202 N Main St
Jefferson, WI 53549-1149
Phone
(920) 674-5025
Fax
(920) 674-5253
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2506 WI Primary

Addresses

Primary practice location

202 N Main St
Jefferson, WI 53549-1149

Mailing address

1015 S 8TH St
Watertown, WI 53094-4742
Phone (920) 262-1877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120202000589 WI Practitioner - Chiropractic 4385801398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

202 N Main St
Jefferson, WI 53549-1149
Phone (920) 674-5025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Health Enterprises LLC Chiropractor CurrentSince Jan 1, 2017 Accepting new patients
Central Jefferson Chiropractic Chiropractor PastSince Jan 1, 2017 Accepting new patients

Locations

202 N Main St
Jefferson, WI 53549
Phone (920) 674-5025

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1700964228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1015 S 8TH ST",
            "city": "WATERTOWN",
            "state": "WI",
            "postal_code": "530944742",
            "telephone_number": "920-262-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 N MAIN ST",
            "city": "JEFFERSON",
            "state": "WI",
            "postal_code": "535491149",
            "telephone_number": "920-674-5025",
            "fax_number": "920-674-5253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ALAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "2506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.