Active NPI
John Marshall Lewis, MSN FNP-C
- Family Nurse Practitioner
- Broken Arrow, OK
National Provider Identifier
1962118596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F01230016
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| F01230016 | OK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healwell, LLC | Family | Current | 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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.