Stacey Lewis

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

4040 N Martin L King Blvd Ste a
North Las Vegas, NV 89032-3205

Phone

(702) 644-4673

Fax

(702) 902-5443

NPI assigned

May 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1306195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1871886853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 LAKE SAHARA DR",
            "address_2": "SUITE 108",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891173438",
            "telephone_number": "702-222-0792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 N MARTIN L KING BLVD STE A",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890323205",
            "telephone_number": "702-644-4673",
            "fax_number": "702-902-5443"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2760 Lake Sahara Dr",
            "address_2": "Suite 108",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891173438",
            "country_code": "US",
            "telephone_number": "702-222-0792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "STACEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-24",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "NV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrice Lewis
• Ronald Keith Lewis, CRT
• Sandra Fay Lewis, LCSW
• Sandra J Lewis
• Saquoia Lewis
• Feng Ming Li
• Jesus Li
• Kenny Li
• Lototele Liaina
• Michael Licata

• Community Health Worker in North Las Vegas, NV
• Providers in North Las Vegas, NV by specialty
• Community Health Worker in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.