Active NPI
Benjamin Dean Lewis, L.M.T., M.M.P.
- Massage Therapist
- Idaho Falls, ID
National Provider Identifier
1992964894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- Practice address
- 2539 Channing Way
Suite 102
Idaho Falls, ID 83404-7544 - Phone
- (208) 403-2262
- NPI assigned
- Jun 5, 2008
- 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 |
|---|---|---|---|---|
| Massage Therapist | 225700000X | Primary |
Addresses
Primary practice location
2539 Channing Way
Suite 102
Idaho Falls, ID 83404-7544
Mailing address
2539 Channing Way
Suite 102
Idaho Falls, ID 83404-7544
Phone (208) 403-2262
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212624000000",
"number": "1992964894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2539 CHANNING WAY",
"address_2": "SUITE 102",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047544",
"telephone_number": "208-403-2262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2539 CHANNING WAY",
"address_2": "SUITE 102",
"city": "IDAHO FALLS",
"state": "ID",
"postal_code": "834047544",
"telephone_number": "208-403-2262"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "BENJAMIN",
"middle_name": "DEAN",
"name_prefix": "Mr.",
"credential": "L.M.T., M.M.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-06-05",
"last_updated": "2008-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Idaho Falls, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.