Individual provider Active NPI

Regina Lewis, FNP

  • Family Nurse Practitioner
  • Cape Girardeau, MO
National Provider Identifier
1902951429
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
086348 Issued in MO
Practice address
1702 N Kingshighway St
Cape Girardeau, MO 63701-2122
Phone
(573) 339-2000
Fax
(573) 339-1876
NPI assigned
Jan 24, 2007
Last updated
Mar 4, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3013333 KY
Family Nurse Practitioner 363LF0000X 086348 MO Primary

Addresses

Primary practice location

1702 N Kingshighway St
Cape Girardeau, MO 63701-2122

Mailing address

PO Box 801143
Kansas City, MO 64180-1143
Phone (573) 331-5583

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
I20190815003622 KY Practitioner - Nurse Practitioner 7113113754 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3013333KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Marshall County Health Dept CurrentSince Jul 1, 2019 Accepting new patients
Fast Pace Kentucky PLLC Family CurrentSince Jan 1, 2020 Accepting new patients
Fast Pace Kentucky, PLLC CurrentSince Jan 1, 2020 Accepting new patients
Poplar Bluff Regional Medical Center, LLC PastSince Jul 2, 2014 Accepting new patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients
Poplar Bluff Regional Medical Center LLC Past Accepting new patients

Locations

267 Slickback Rd
Benton, KY 42025
Phone (270) 527-1496

401 Main St
Benton, KY 42025
Phone (270) 906-0369

1475 Nashville Rd
Franklin, KY 42134
Phone (270) 813-1111

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1902951429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 N KINGSHIGHWAY ST",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637012122",
            "telephone_number": "573-339-2000",
            "fax_number": "573-339-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "REGINA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013333",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "086348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.