Individual provider Active NPI

Carol T Lewis, MD

  • Pediatrics Physician
  • Providence, RI
National Provider Identifier
1962456921
Registry record updated Jun 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
06400 Issued in RI
Practice address
593 Eddy St
Hasbro Lower Level
Providence, RI 02903-4923
Phone
(401) 444-3850
Fax
(401) 444-3870
NPI assigned
May 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 06400 RI Primary

Addresses

Primary practice location

593 Eddy St
Hasbro Lower Level
Providence, RI 02903-4923

Mailing address

593 Eddy St
Hasbro 122
Providence, RI 02903-4923
Phone (401) 444-6484

Other identifiers 1

IdentifierTypeStateIssuer
7010293MedicaidRI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051130000451 RI Practitioner - Pediatric Medicine 1153341938 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
06400RIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rhode Island Hospital Pediatrics CurrentSince Jan 1, 2015 Accepting new patients
Rhode Island Hospital CurrentSince Jan 1, 2015 Accepting new patients
Lifespan Corporation Current Accepting new patients
Rhode Island Hospital Past Accepting new patients
Rhode Island Hospital Past Accepting new patients

Locations

593 Eddy St
Ste 5
Providence, RI 02903
Phone (401) 444-3996

593 Eddy St
#122
Providence, RI 02903
Phone (401) 444-6195

593 Eddy St
Providence, RI 02903

593 Eddy St
#921
Providence, RI 02903
Phone (401) 444-3250

593 Eddy St
Lowr
Providence, RI 02903
Phone (401) 444-4471

Interoperability endpoints

  • Direct secure messaging: clewis8867@brownhealth.medalliesdirect.net

Organizations & group practices 5

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": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276560000000",
    "number": "1962456921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "HASBRO 122",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-6484",
            "fax_number": "401-444-6378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "address_2": "HASBRO LOWER LEVEL",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-3850",
            "fax_number": "401-444-3870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CAROL",
        "middle_name": "T",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2010-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "RI",
            "license": "06400",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7010293",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.