Individual provider Active NPI

Sara Ann Lewis, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Wellington, FL
National Provider Identifier
1811999378
Registry record updated Dec 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2026462 Issued in FL
Practice address
12200 Forest Hill Blvd
Wellington, FL 33414-5795
Phone
(561) 303-0433
Fax
(561) 303-0433
NPI assigned
Aug 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X ARNP 2026462 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2026462 FL Primary

Addresses

Primary practice location

12200 Forest Hill Blvd
Wellington, FL 33414-5795

Mailing address

2646 Danforth Ter
Wellington, FL 33414-3433
Phone (561) 303-0433

Other identifiers 1

IdentifierTypeStateIssuer
303558100MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Desktop

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20200221000490 FL Practitioner - Nurse Practitioner 4688001241

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2646 Danforth Ter
Wellington, FL 33414-3433

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP 2026462FLMDPediatrics Physician
2026462FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lewis Family Psychiatry, LLC CurrentSince Jan 3, 2020 Accepting new patients
Community Christian Counseling Center Past Accepting new patients

Locations

12200 Forest Hill Blvd
Wellington, FL 33414
Phone (561) 303-0433

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577059200000",
    "number": "1811999378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 DANFORTH TER",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334143433",
            "telephone_number": "561-303-0433",
            "fax_number": "561-303-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 FOREST HILL BLVD",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334145795",
            "telephone_number": "561-303-0433",
            "fax_number": "561-303-0433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SARA",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-15",
        "last_updated": "2019-12-23",
        "certification_date": "2019-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ARNP 2026462",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2026462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "303558100",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Desktop",
            "affiliation": "N",
            "address_1": "12200 Forest Hill Blvd",
            "city": "Wellington",
            "state": "FL",
            "country_code": "US",
            "postal_code": "334145795",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

Verify at the official NPI Registry.