Individual provider Active NPI

Lucreasie Lewis, ARNP

  • Women's Health Nurse Practitioner
  • Hazard, KY
National Provider Identifier
1821070053
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
2973P Issued in KY
Practice address
441 Gorman Hollow Rd
Hazard, KY 41701-2315
Phone
(606) 439-2361
Fax
(606) 439-0870
NPI assigned
Nov 15, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X 1058965 KY
Women's Health Nurse Practitioner 363LW0102X 2973P KY Primary

Addresses

Primary practice location

441 Gorman Hollow Rd
Hazard, KY 41701-2315

Mailing address

441 Gorman Hollow Rd
Hazard, KY 41701-2315
Phone (606) 439-2361

Other identifiers 2

IdentifierTypeStateIssuer
000000112279OtherKYANTHEM BC BS
20036018MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050624000269 KY Practitioner - Nurse Practitioner 2860437316 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1058965KYMDCommunity Health Registered Nurse
2973PKYMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kentucky River District Health Department CurrentSince Jan 1, 2010 Accepting new patients
Kentucky River District Health Department Past Accepting new patients
Kentucky River District Health Department Past Accepting new patients
Kentucky River District Health Department Past Accepting new patients

Locations

48 Center St
Beattyville, KY 41311
Phone (606) 464-2492

441 Gorman Hollow Rd
Hazard, KY 41701
Phone (606) 439-2361

880 W Main St
Hindman, KY 41822
Phone (606) 785-3144

Organizations & group practices 5

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": "1132012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1821070053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "441 GORMAN HOLLOW RD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012315",
            "telephone_number": "606-439-2361",
            "fax_number": "606-439-0870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "441 GORMAN HOLLOW RD",
            "city": "HAZARD",
            "state": "KY",
            "postal_code": "417012315",
            "telephone_number": "606-439-2361",
            "fax_number": "606-439-0870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LUCREASIE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-15",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "KY",
            "license": "1058965",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "KY",
            "license": "2973P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC BS",
            "identifier": "000000112279",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "20036018",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazard, KY

Sources for this page

Verify at the official NPI Registry.