Kelly A Lewis, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

4704271476 Issued in MI

Practice address

19714 E 10 Mile Rd
Saint Clair Shores, MI 48080-1064

Phone

(586) 779-9400

NPI assigned

Sep 25, 2016

Last updated

Mar 3, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI2 enrollments

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 2

Specialty

Certified Nurse Midwife (CNM)

Education

Wayne State University School of Medicine, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

A Ahmad MD PLCGroup PAC ID 9931444783, 6 clinicians

Im ConsultantGroup PAC ID 2567893316, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Grosse Pointe Hospital, Grosse Pointe, MI, CCN 230089

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• A Ahmad MD PLC

  dba Primedical Care PLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1306313515
  Medicare reassignment Care Compare group NPD
• Im Consultant

  dba Primedical Urgent Care 1

  • Urgent Care Clinic/Center
  • Detroit, MI
  • NPI 1023644242
  Medicare reassignment Care Compare group NPD
• Primedical Healthcare Associates PLLC

  • Internal Medicine Physician
  • Detroit, MI
  • NPI 1396521662
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1811044878
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Grosse Pointe

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1474761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1942759543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19714 E 10 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801064",
            "telephone_number": "248-909-1067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19714 E 10 MILE RD",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480801064",
            "telephone_number": "586-779-9400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "46591 Romeo Plank Rd Ste 225",
            "address_purpose": "LOCATION",
            "city": "Macomb",
            "state": "MI",
            "postal_code": "480445743",
            "country_code": "US",
            "telephone_number": "586-226-6155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KELLY",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-25",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MI",
            "license": "4704271476",
            "primary": false
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MI",
            "license": "4704271476",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704271476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Leone, DDS MS
• Let's Talk Kids, Inc
• Lauren Marie Letzmann
• John Andrew Leverenz, DDS
• John Robert Leverenz, D.D.S.
• Tamika Rainelle Lewis
• Lianee Tait, LMSW
• Ashley Lietzau
• Life Transition Services LLC
• Life Transitions Services LLC

• Nurse Practitioner in Saint Clair Shores, MI
• Providers in Saint Clair Shores, MI by specialty
• Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.