NPIMap

Organization Active NPI

Lewis 360 Medical Solutions PLLC

  • Anesthesiology Physician
  • Fort Worth, TX
National Provider Identifier
1932509635
Registry record updated Aug 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
40272 Issued in TX
Legal business name
LEWIS 360 MEDICAL SOLUTIONS PLLC
Practice address
2120 Mistletoe Blvd Unit 2
Fort Worth, TX 76110-1174
Phone
(817) 927-8900
Fax
(817) 927-8902
NPI assigned
Aug 29, 2014
Last updated
Aug 29, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2014

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

Authorized official

Name
Antonia Kay Lewis, CRNANPI 1841302924
Title
Owner/President
Phone
(817) 927-8900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 532304 TX
Anesthesiology Physician 207L00000X 40272 TX Primary

Addresses

Primary practice location

2120 Mistletoe Blvd Unit 2
Fort Worth, TX 76110-1174

Mailing address

2120 Mistletoe Blvd Unit 2
Fort Worth, TX 76110-1174
Phone (817) 927-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141118000457 TX Part B Supplier - Clinic/Group Practice 2466674924 Receives reassigned benefits from 33 practitioners
Practice locations: Fort Worth, TX

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

2120 Mistletoe Blvd
Unit 2
Fort Worth, TX 76110
Phone (817) 926-6100

Practitioners & affiliated clinicians

Practitioners 34

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 34

NPI Registry JSON

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

{
    "created_epoch": "1409270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1409270400000",
    "number": "1932509635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 MISTLETOE BLVD UNIT 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101174",
            "telephone_number": "817-927-8900",
            "fax_number": "817-927-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 MISTLETOE BLVD UNIT 2",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101174",
            "telephone_number": "817-927-8900",
            "fax_number": "817-927-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEWIS 360 MEDICAL SOLUTIONS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-29",
        "last_updated": "2014-08-29",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "ANTONIA",
        "authorized_official_middle_name": "KAY",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "817-927-8900",
        "authorized_official_credential": "CRNA"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "532304",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "40272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.