Individual provider Active NPI

Brandi Mickale Lewis, CNP

  • Family Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1740316066
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN.CNP.021012 Issued in OH
Practice address
1710 Prospect Ave E
Cleveland, OH 44115-2322
Phone
(216) 645-0146
Fax
(216) 781-2023
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.021012 OH Primary

Addresses

Primary practice location

1710 Prospect Ave E
Cleveland, OH 44115-2322

Mailing address

7584 Sheffield CT
Macedonia, OH 44056-2272
Phone (330) 468-2086

Other practice location 1

7584 Sheffield Ct
Macedonia, OH 44056-2272
Phone (330) 468-2086

Other identifiers 1

IdentifierTypeStateIssuer
0228085MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180921001738 OH Practitioner - Nurse Practitioner 2668723131 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26777 Lorain Rd
Suite 716
North Olmsted, OH 44070-3221

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN.CNP.021012OHMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Faith Medical Associates, Inc CurrentSince Aug 18, 2018 Accepting new patients
Nancy Duff-Boehm, PHD & Asssociates LLC Past Accepting new patients

Locations

11201 Shaker Blvd
Ste 240
Cleveland, OH 44104
Phone (216) 359-3469

Organizations & group practices 3

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1740316066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7584 SHEFFIELD CT",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "440562272",
            "telephone_number": "330-468-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1710 PROSPECT AVE E",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441152322",
            "telephone_number": "216-645-0146",
            "fax_number": "216-781-2023"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7584 Sheffield Ct",
            "address_purpose": "LOCATION",
            "city": "Macedonia",
            "state": "OH",
            "postal_code": "440562272",
            "country_code": "US",
            "telephone_number": "330-468-2086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "BRANDI",
        "middle_name": "MICKALE",
        "name_prefix": "Mrs.",
        "credential": "CNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.021012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0228085",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.