Active NPI
Anthony Evan Lewis, M.D.
- Internal Medicine Physician
- Kingsport, TN
National Provider Identifier
1912923442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 24434
- Practice address
- 130 W Ravine Rd
Kingsport, TN 37660-3837 - Phone
- (423) 224-3628
- Fax
- (423) 230-8502
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101249890 | VA | |
| Internal Medicine Physician | 207R00000X | 24434 | TN | Primary |
Addresses
Primary practice location
130 W Ravine Rd
Kingsport, TN 37660-3837
Mailing address
105 W Stone Dr
Suite 6a
Kingsport, TN 37660-3365
Phone (423) 408-7220
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7100109560 | Medicaid | KY | |
| 1912923442 | Medicaid | VA | |
| 1510062 | Medicaid | TN | |
| 1912923442 | Medicaid | NC | |
| Q002676 | Medicaid | TN |
Other names 1
- A Evan Lewis
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24434 | TN | MD | Internal Medicine Physician |
| 0101249890 | VA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1427414400000",
"number": "1912923442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 W STONE DR",
"address_2": "SUITE 6A",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603365",
"telephone_number": "423-408-7220",
"fax_number": "423-408-7405"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 W RAVINE RD",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376603837",
"telephone_number": "423-224-3628",
"fax_number": "423-230-8502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "ANTHONY",
"middle_name": "EVAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2015-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101249890",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TN",
"license": "24434",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7100109560",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912923442",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1510062",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1912923442",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q002676",
"state": "TN"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "A",
"last_name": "LEWIS",
"middle_name": "EVAN",
"credential": "MD",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.