Active NPI
Kragen Deshawn Lewis, DPT
- Physical Therapist
- Copperas Cove, TX
National Provider Identifier
1801452685
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1316214
- Practice address
- 181 W Business 190 Ste 5
Copperas Cove, TX 76522-3672 - Phone
- (318) 471-2010
- NPI assigned
- May 16, 2019
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 1316214 | TX | Primary |
Addresses
Primary practice location
181 W Business 190 Ste 5
Copperas Cove, TX 76522-3672
Mailing address
7201 Wood Hollow Dr Apt 475
Austin, TX 78731-3049
Phone (318) 471-2010
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1316214 | TX | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1557964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1557964800000",
"number": "1801452685",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7201 WOOD HOLLOW DR APT 475",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787313049",
"telephone_number": "318-471-2010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 W BUSINESS 190 STE 5",
"city": "COPPERAS COVE",
"state": "TX",
"postal_code": "765223672",
"telephone_number": "318-471-2010"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "KRAGEN",
"middle_name": "DESHAWN",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-05-16",
"last_updated": "2019-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TX",
"license": "1316214",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Copperas Cove, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.