Individual provider Active NPI

Lacey Catrice Lewis, FNP

  • Family Nurse Practitioner
  • Lubbock, TX
National Provider Identifier
1811537236
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP142221 Issued in TX
Practice address
1910 Quaker Ave Ste 101
Lubbock, TX 79407-2433
Phone
(806) 725-4440
Fax
(806) 725-4441
NPI assigned
Jan 14, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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 AP142221 TX Primary

Addresses

Primary practice location

1910 Quaker Ave Ste 101
Lubbock, TX 79407-2433

Mailing address

2215 Nashville Ave
Lubbock, TX 79410-1105
Phone (806) 725-5844

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20200323000803 TX Practitioner - Nurse Practitioner 6608204888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical GroupGroup PAC ID 6901889393, 228 clinicians

Practice addresses (Care Compare)

1910 Quaker Ave
Suite 101
Lubbock, TX 79407-2433
Phone (806) 725-4440

Hospital & facility affiliations

  • Covenant Medical Center Hospital, Lubbock, TX, CCN 450040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group CurrentSince Apr 1, 2020 Accepting new patients
Covenant Medical Group CurrentSince Apr 1, 2020 Accepting new patients

Locations

1910 Quaker Ave
Ste 101
Lubbock, TX 79407
Phone (806) 725-4440

2215 Nashville Ave
Lubbock, TX 79410
Phone (806) 725-5228

5202 82nd St
Lubbock, TX 79424
Phone (806) 701-5265

7601 Quaker Ave
Lubbock, TX 79424
Phone (806) 725-9444

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": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1811537236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2215 NASHVILLE AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101105",
            "telephone_number": "806-725-5844",
            "fax_number": "806-723-6532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 QUAKER AVE STE 101",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072433",
            "telephone_number": "806-725-4440",
            "fax_number": "806-725-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LACEY",
        "middle_name": "CATRICE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP142221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.