Cody W Lewis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA2012-0021 Issued in NM

Practice address

2300 E 30TH St BLDG D Ste 101
Farmington, NM 87401

Phone

(505) 327-1400

Fax

(505) 564-3202

NPI assigned

Aug 2, 2012

Last updated

Jan 18, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NM, TX, CO3 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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Orthopedic Associates PA

  • Orthopaedic Surgery Physician
  • Farmington, NM
  • NPI 1750356820
  Medicare reassignment NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  dba Northern Navajo Medical Center

  • General Acute Care Hospital
  • Shiprock, NM
  • NPI 1780639971

  TX

  Medicare reassignment
• Presbyterian Medical Services

  dba Rio Rancho Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Rio Rancho, NM
  • NPI 1871505032
  Medicare reassignment
• San Juan Oncology Associates, PC

  • Hematology & Oncology Physician
  • Farmington, NM
  • NPI 1558446187

  CO

  Medicare reassignment
• DHHS, PHS, Naihs, Shiprock Hospital

  dba Dzilth-Na-O-Dith-Hle Health Center

  • General Acute Care Hospital
  • Bloomfield, NM
  • NPI 1760427587
  NPD
• Presbyterian Medical Services

  dba PMS Central Pharmacy

  • Community/Retail Pharmacy
  • Albuquerque, NM
  • NPI 1306654462
  NPD
• Presbyterian Medical Services

  dba Carlsbad Family Health Center Behavioral Health

  • Clinic/Center
  • Carlsbad, NM
  • NPI 1629468830
  NPD
• DHHS, PHS, Naihs, Shiprock Hospital

  • General Acute Care Hospital
  • Teec Nos Pos, AZ
  • NPI 1477615789
  NPD
• San Juan Oncology Associates, PC

  • Hematology & Oncology Physician
  • Durango, CO
  • NPI 1144893249
  NPD

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

{
    "created_epoch": "1343865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610928000000",
    "number": "1972859403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST BLDG D STE 101",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87401",
            "telephone_number": "505-327-1400",
            "fax_number": "505-564-3202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 E 30TH ST BLDG D STE 101",
            "city": "FARMINGTON",
            "state": "NM",
            "postal_code": "87401",
            "telephone_number": "505-327-1400",
            "fax_number": "505-564-3202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5600 Eubank Blvd NE Ste 110",
            "address_purpose": "LOCATION",
            "city": "Albuquerque",
            "state": "NM",
            "postal_code": "87111",
            "country_code": "US",
            "telephone_number": "505-880-1920",
            "fax_number": "505-200-2852",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "87401",
            "country_code": "US",
            "telephone_number": "505-327-4796",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1001 W Broadway",
            "address_purpose": "LOCATION",
            "city": "Farmington",
            "state": "NM",
            "postal_code": "87401",
            "country_code": "US",
            "telephone_number": "505-327-4796",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CODY",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-02",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA60796883",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NM",
            "license": "PA2012-0021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Lesser
• Christopher Lesueur, DO
• Stephanie A Lew, CRNA
• Brianna Lewis, PHARMD
• Christy Lewis, RN
• Gerald A. Lewis
• Justin Lewis
• Krista Lewis
• Ronald Alan Tung Li, M.D.
• Life Quality Chiropractic, LLC

• Medical Physician Assistant in Farmington, NM
• Providers in Farmington, NM by specialty
• Medical Physician Assistant in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.