Individual provider Active NPI

Claire Alexis Lewellen, APRN

  • Nurse Practitioner
  • Gainesville, FL
National Provider Identifier
1740877588
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11010645 Issued in FL
Practice address
Division of Burn/Trauma 100108
Gainesville, FL 32610-3003
Phone
(352) 273-5670
NPI assigned
Dec 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X APRN11010645 FL
Nurse Practitioner 363L00000X APRN11010645 FL Primary

Addresses

Primary practice location

Division of Burn/Trauma 100108
Gainesville, FL 32610-3003

Mailing address

1600 SW Archer Rd
Box 100108
Gainesville, FL 32610
Phone (352) 273-5670

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 273-5670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20220308000613 MD Practitioner - Nurse Practitioner 1658786603 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Maryland Community Medical Group IncGroup PAC ID 3678472214, 446 clinicians

Practice addresses (Care Compare)

301 Hospital Dr
Glen Burnie, MD 21061-5803
Phone (410) 787-4000

Hospital & facility affiliations

  • University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Community Medical Group, Inc. CurrentSince Feb 27, 2022 Accepting new patients
University of Maryland Community Medical Group, Inc. CurrentSince Feb 27, 2022 Accepting new patients

Locations

2540 Centreville Rd
Centreville, MD 21617
Phone (410) 758-4432

219 S Washington St
Easton, MD 21601

301 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 787-4565

900 Elkridge Landing Rd
Fl 2
Linthicum Heights, MD 21090
Phone (443) 462-5010

Interoperability endpoints

  • Direct secure messaging: mmengistu870154@direct.umm.edu

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1740877588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "address_2": "BOX 100108",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32610",
            "telephone_number": "352-273-5670",
            "fax_number": "352-273-5683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DIVISION OF BURN/TRAUMA 100108",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003",
            "telephone_number": "352-273-5670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-273-5670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWELLEN",
        "first_name": "CLAIRE",
        "middle_name": "ALEXIS",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "APRN11010645",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11010645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.