Individual provider Active NPI

Elizabeth Lewis, PA-C

  • Medical Physician Assistant
  • Sherwood, OR
National Provider Identifier
1821393794
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA153746 Issued in OR
Practice address
20015 SW Pacific Hwy Ste 300
Sherwood, OR 97140-9316
Phone
(503) 625-2848
Fax
(503) 625-2899
NPI assigned
Jan 24, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA153746 OR Primary

Addresses

Primary practice location

20015 SW Pacific Hwy Ste 300
Sherwood, OR 97140-9316

Mailing address

20015 SW Pacific Hwy Ste 300
Sherwood, OR 97140-9316
Phone (503) 625-2848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20170623000470 VT Practitioner - Physician Assistant 3577831163 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA153746ORMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Porter Hospital, Inc CurrentSince May 6, 2017 Accepting new patients
Sherwood Family Medicine PC PastSince Mar 1, 2008 Accepting new patients
Sherwood Family Medicine Past Accepting new patients

Locations

61 Court Dr
Brandon, VT 05733
Phone (802) 247-3755

116 Porter Dr
Middlebury, VT 05753
Phone (802) 388-6326

104 Porter Dr
Middlebury, VT 05753
Phone (802) 388-5682

82 Catamount Park
Middlebury, VT 05753
Phone (802) 388-7185

10 North St
Vergennes, VT 05491
Phone (802) 877-3466

Organizations & group practices 3

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": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1821393794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20015 SW PACIFIC HWY STE 300",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409316",
            "telephone_number": "503-625-2848",
            "fax_number": "503-625-2899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20015 SW PACIFIC HWY STE 300",
            "city": "SHERWOOD",
            "state": "OR",
            "postal_code": "971409316",
            "telephone_number": "503-625-2848",
            "fax_number": "503-625-2899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OR",
            "license": "PA153746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sherwood, OR

Sources for this page

Verify at the official NPI Registry.