Individual provider Active NPI

John Marshall Lewis, MSN FNP-C

  • Family Nurse Practitioner
  • Broken Arrow, OK
National Provider Identifier
1962118596
Registry record updated Jan 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F01230016 Issued in OK
Practice address
30239 E 69TH PL S
Broken Arrow, OK 74014-5483
Phone
(918) 289-8154
NPI assigned
Jan 26, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F01230016 OK Primary

Addresses

Primary practice location

30239 E 69TH PL S
Broken Arrow, OK 74014-5483

Mailing address

30239 E 69TH PL S
Broken Arrow, OK 74014-5483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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
I20231122001339 OK Practitioner - Nurse Practitioner 6103274642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healwell LLC 16 clinicians

Practice addresses (Care Compare)

2801 Parklawn Dr
Suite 302
Midwest City, OK 73110-4230
Phone (405) 492-7229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F01230016OKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Healwell, LLC Family CurrentSince Sep 27, 2023 Accepting new patients

Locations

2801 Parklawn Dr
Ste 302
Oklahoma City, OK 73110
Phone (405) 492-7229

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1674691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674691200000",
    "number": "1962118596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30239 E 69TH PL S",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740145483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30239 E 69TH PL S",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740145483",
            "telephone_number": "918-289-8154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JOHN",
        "middle_name": "MARSHALL",
        "credential": "MSN FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-01-26",
        "last_updated": "2023-01-26",
        "certification_date": "2023-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "F01230016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broken Arrow, OK

Sources for this page

Verify at the official NPI Registry.