Individual provider Active NPI

Robbin Desiree Lewis Jr.

  • Nurse Practitioner
  • East Chicago, IN
National Provider Identifier
1720225873
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71007997A Issued in IN
Practice address
4321 Fir St
East Chicago, IN 46312
Phone
(219) 392-7025
NPI assigned
Jan 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 00000000000 WA
Nurse Practitioner 363L00000X F05170502 IL
Nurse Practitioner 363L00000X 71007997A IN Primary

Addresses

Primary practice location

4321 Fir St
East Chicago, IN 46312

Mailing address

4321 Fir St
East Chicago, IN 46312-3049
Phone (219) 392-7025

Other practice location 1

3101 Longfellow Ave
Hazel Crest, IL 60429-1654
Phone (360) 618-2871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
00000000000WAMDPharmacist
F05170502ILMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1231718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720225873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4321 FIR ST",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "463123049",
            "telephone_number": "219-392-7025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4321 FIR ST",
            "city": "EAST CHICAGO",
            "state": "IN",
            "postal_code": "46312",
            "telephone_number": "219-392-7025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3101 Longfellow Ave",
            "address_purpose": "LOCATION",
            "city": "Hazel Crest",
            "state": "IL",
            "postal_code": "604291654",
            "country_code": "US",
            "telephone_number": "360-618-2871",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ROBBIN",
        "middle_name": "DESIREE",
        "name_prefix": "Ms.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-12",
        "last_updated": "2022-07-21",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "00000000000",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "F05170502",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71007997A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Chicago, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.