Active NPI
Matthew Lewis, MS, AT, ATC
- Athletic Trainer
- Grand Rapids, MI
National Provider Identifier
1982033734
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 2601000848
- Practice address
- 3902 Whispering Way SE
3
Grand Rapids, MI 49546-5877 - Phone
- (616) 818-9656
- NPI assigned
- Nov 2, 2013
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 2601000848 | MI | Primary |
Addresses
Primary practice location
3902 Whispering Way SE
3
Grand Rapids, MI 49546-5877
Mailing address
4100 Lake Dr SE
300
Grand Rapids, MI 49546-8292
Phone (616) 267-8860
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2601000848 | MI | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383350400000",
"number": "1982033734",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4100 LAKE DR SE",
"address_2": "300",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495468292",
"telephone_number": "616-267-8860",
"fax_number": "616-267-8442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3902 WHISPERING WAY SE",
"address_2": "3",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495465877",
"telephone_number": "616-818-9656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "MATTHEW",
"name_prefix": "Mr.",
"credential": "MS, AT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-02",
"last_updated": "2013-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "MI",
"license": "2601000848",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.