Individual provider Active NPI

Shevone C Lewis

  • Women's Health Nurse Practitioner
  • Littleton, CO
National Provider Identifier
1841717543
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
11036110 Issued in FL
Practice address
7383 W Grant Ranch Blvd Apt 1725
Littleton, CO 80123-2668
Phone
(347) 267-2943
Fax
(347) 267-2943
NPI assigned
Aug 24, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.1643039 CO
Women's Health Nurse Practitioner 363LW0102X 11036110 FL Primary

Addresses

Primary practice location

7383 W Grant Ranch Blvd Apt 1725
Littleton, CO 80123-2668

Mailing address

6306 S Macdill Ave Apt 429
Tampa, FL 33611-5072
Phone (347) 267-2943

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
I20250324000765 FL Practitioner - Nurse Practitioner 2365964962 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN.1643039COMDRegistered Nurse
11036110FLMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Karon R Locicero MD PA CurrentSince Jan 27, 2025 Accepting new patients

Locations

888 S Parsons Ave
Brandon, FL 33511
Phone (813) 684-2273

2605 W Swann Ave
Ste 600
Tampa, FL 33609
Phone (813) 870-2528

110 S Macdill Ave
Ste 300
Tampa, FL 33609
Phone (813) 331-4465

110 S Macdill Ave
Tampa, FL 33609
Phone (813) 564-0140

Organizations & group practices 1

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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730678400000",
    "number": "1841717543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6306 S MACDILL AVE APT 429",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336115072",
            "telephone_number": "347-267-2943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7383 W GRANT RANCH BLVD APT 1725",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801232668",
            "telephone_number": "347-267-2943",
            "fax_number": "347-267-2943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SHEVONE",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CO",
            "license": "RN.1643039",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "FL",
            "license": "11036110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

Verify at the official NPI Registry.