Active NPI
Alice Bernice Lewis, PA
- Physician Assistant
- South Kortright, NY
National Provider Identifier
1740510213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 004036-1
- Practice address
- 57081 State Highway 10
South Kortright, NY 13842-2043 - Phone
- (607) 538-1401
- Fax
- (607) 538-1403
- NPI assigned
- Jan 6, 2010
- Last updated
- Jan 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 004036-1 | NY | Primary |
Addresses
Primary practice location
57081 State Highway 10
South Kortright, NY 13842-2043
Mailing address
57081 State Highway 10
South Kortright, NY 13842-2043
Phone (607) 538-1401
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004036-1 | NY | MD | Geriatric Medicine (Internal Medicine) Physician |
Interoperability endpoints
- alewis@landmarkhealth-direct.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262736000000",
"number": "1740510213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57081 STATE HIGHWAY 10",
"city": "SOUTH KORTRIGHT",
"state": "NY",
"postal_code": "138422043",
"telephone_number": "607-538-1401",
"fax_number": "607-538-1403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57081 STATE HIGHWAY 10",
"city": "SOUTH KORTRIGHT",
"state": "NY",
"postal_code": "138422043",
"telephone_number": "607-538-1401",
"fax_number": "607-538-1403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "ALICE",
"middle_name": "BERNICE",
"name_prefix": "Ms.",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-06",
"last_updated": "2010-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NY",
"license": "004036-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Kortright, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.