Angela Dawn Lewis, DO
Individual provider Active NPI Family Medicine Physician · Russell, KY
NPI 1710073580 · NPPES record last updated Jan 5, 2011
Key facts
- NPI
- 1710073580
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- KY02545 (KY)
- Practice address
- 1021 Kenwood Dr
Russell, KY 41169 - Phone
- (606) 836-1954
- Fax
- (606) 836-3878
- NPI assigned
- Oct 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 7
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- West Virginia School of Osteopathic Medicine, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Premier Therapy and Health Centers Inc
Practice addresses (Care Compare)
1021 Kenwood Dr
Russell, KY 41169-1527
Phone (606) 836-1954
2400 13TH St
Ashland, KY 41102-4510
Phone (606) 329-0910
Hospital & facility affiliations
- King'S Daughters' Medical Center HHA
- Community Hospice
- King'S Daughters' Medical Center
- Kings Daughters Medical Center Ohio
- Southern Ohio Medical Center
- St Marys Medical Center
Merit-based Incentive Payment System (MIPS)
- Final score
- 52.44 of 100
- Quality
- 70.07
- Improvement activities
- 0
- Cost
- 81.39
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101104000377 | KY | Practitioner - Family Practice | 7810181757 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY02545 | KY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Angela D Lewis DO PSC | Family Medicine | Current |
Accepting new patients |
Locations
1021 Kenwood Dr
Russell, KY 41169
Phone (606) 836-1954
Interoperability endpoints
- alewis72383@direct.kdhealth.us
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | KY02545 | KY | Yes |
Addresses
Primary practice location
1021 Kenwood Dr
Russell, KY 41169
Mailing address
1021 Kenwood Dr
Russell, KY 41169
Phone (606) 836-1954
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64025455 | Medicaid | KY | |
| 080127343 | Other | KY | RAILROAD MEDICARE |
Other providers in Russell, KY
- Interhope Christian Counseling PLLC
- Allison Charee Jackson
- Courtney Joyce
- Melissa Gayle King
- Lana J Davenport MD PLC
- Susan M. Lichtenberger
- Manish Parikh MD
- Nadele McCarty
- Elmer H Mullins Jr.
- Nurseology, LLC
All providers in Russell, KY · Family Medicine Physician in Kentucky
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.