Active NPI
John Braxton Lewis, OD
- Optometrist
- Venice, FL
National Provider Identifier
1982709341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OPC1163
- Practice address
- 1236 Jacaranda Blvd
Venice, FL 34292 - Phone
- (941) 496-4444
- Fax
- (941) 496-4223
- NPI assigned
- Sep 13, 2006
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | OPC1163 | FL | Primary |
Addresses
Primary practice location
1236 Jacaranda Blvd
Venice, FL 34292
Mailing address
1360 E Venice Ave
Venice, FL 34285-9066
Phone (941) 480-2135
Other practice location 1
1360 E Venice Ave
Venice, FL 34285-9066
Phone (941) 480-2135
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 078516400 | Medicaid | FL |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | jlewis@centerforsight.intellechartdirect.net | Center For Sight, PL |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OPC1163 | FL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701043200000",
"number": "1982709341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1360 E VENICE AVE",
"city": "VENICE",
"state": "FL",
"postal_code": "342859066",
"telephone_number": "941-480-2135",
"fax_number": "941-484-2200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1236 JACARANDA BLVD",
"city": "VENICE",
"state": "FL",
"postal_code": "34292",
"telephone_number": "941-496-4444",
"fax_number": "941-496-4223"
}
],
"practiceLocations": [
{
"address_1": "1360 E Venice Ave",
"address_purpose": "LOCATION",
"city": "Venice",
"state": "FL",
"postal_code": "342859066",
"country_code": "US",
"telephone_number": "941-480-2135",
"fax_number": "941-484-2200",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "JOHN",
"middle_name": "BRAXTON",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-13",
"last_updated": "2023-11-27",
"certification_date": "2020-05-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "FL",
"license": "OPC1163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "078516400",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "jlewis@centerforsight.intellechartdirect.net",
"affiliation": "Y",
"affiliationName": "Center For Sight, PL",
"address_1": "1236 Jacaranda Blvd",
"city": "Venice",
"state": "FL",
"country_code": "US",
"postal_code": "34292",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Venice, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.