Active NPI
Kelly Fuller Lewis, M.D.
- Pediatrics Physician
- Flower Mound, TX
National Provider Identifier
1992186597
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- R7519
- Practice address
- 3041 Churchill Dr Ste 300
Flower Mound, TX 75022 - Phone
- (972) 691-1240
- Fax
- (972) 691-2073
- NPI assigned
- Jun 9, 2015
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | R7519 | TX | Primary |
Addresses
Primary practice location
3041 Churchill Dr Ste 300
Flower Mound, TX 75022
Mailing address
3041 Churchill Dr Ste 300
Flower Mound, TX 75022-5906
Phone (972) 691-1240
Other practice location 1
1901 SW H K Dodgen Loop
Temple, TX 76502
Phone (254) 935-5063
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R7519 | TX | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 18 And Under MD, PA | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- klewis279185@direct.childrens.com
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.
-
- Pediatrics Physician
- Flower Mound, TX
- NPI 1295932325
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433808000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1538352000000",
"number": "1992186597",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3041 CHURCHILL DR STE 300",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "750225906",
"telephone_number": "972-691-1240",
"fax_number": "972-691-2073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3041 CHURCHILL DR STE 300",
"city": "FLOWER MOUND",
"state": "TX",
"postal_code": "75022",
"telephone_number": "972-691-1240",
"fax_number": "972-691-2073"
}
],
"practiceLocations": [
{
"address_1": "1901 SW H K Dodgen Loop",
"address_purpose": "LOCATION",
"city": "Temple",
"state": "TX",
"postal_code": "76502",
"country_code": "US",
"telephone_number": "254-935-5063",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "KELLY",
"middle_name": "FULLER",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-09",
"last_updated": "2018-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "R7519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flower Mound, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.