MR. PETER WALLACE LEWIS (NPI# 1205932944) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1205932944 |
Entity Type | Individual |
Full Name | MR. PETER WALLACE LEWIS |
Credential | PA-C |
Practice Address |
6294 State Highway 154 Sesser IL 62884-2163 |
Mailing Address |
Po Box 155 Christopher IL 62822-0155 |
Practice Telephone | 6186256979 |
Mailing Telephone | 6187242401 |
Mailing Fax Number | 6187244628 |
Enumeration Date | 2006-09-16 |
Last Update Date | 2012-01-18 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA01533 | TX | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689877664 | Peter M Lewis | Dentist | 253 Witherspoon St Ste 253, Princeton, NJ 08540-3211 | 2007-06-07 |
1396286464 | Peter Lewis | Social Worker | 608 S Main St, Culpeper, VA 22701-3210 | 2017-03-09 |
1447413471 | Peter H Lewis | Psychologist | 204 W Hill Blvd, 628th Mdos (mental Health - Bldg 1000), Charleston, SC 29404-4704 | 2008-07-09 |
1366451221 | Peter Adolphus Lewis | Internal Medicine | 5554 Clarcona Ocoee Rd, Orlando, FL 32810-4056 | 2006-08-07 |
1962421404 | Peter James Lewis | Podiatrist | 1050 Warwick Ave, Warwick, RI 02888-3655 | 2006-07-18 |
1902864093 | Peter R Lewis | Family Medicine | 845 Fishburn Rd, Hershey, PA 17033-2015 | 2006-05-01 |
1700869161 | Peter M. Lewis | Internal Medicine | 4000 Miamisburg Centerville Rd, Sutie 100, Miamisburg, OH 45342-7615 | 2005-11-21 |
Street Address |
6294 STATE HIGHWAY 154 |
City | SESSER |
State | IL |
Zip Code | 62884-2163 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679686745 | James J Pavlovich | Pediatrics | 6294 State Highway 154, Sesser, IL 62884 | 2006-08-15 |
1487271557 | Megan Nicole Plummer | Nurse Practitioner | 6294 State Highway 154, Sesser, IL 62884-2163 | 2020-07-06 |
1720550643 | Ashley Lynn Agnew | Licensed Practical Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-12-18 |
1457821423 | Rachel Lynn Sullivan | Registered Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-12-03 |
1053886036 | Toni K Owens | Registered Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-10-05 |
1932686987 | Jilissa M Payne | Dental Hygienist | 6294 State Highway 154, Sesser, IL 62884-2163 | 2018-07-23 |
1366967234 | Olivia Dalby | Registered Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2017-08-11 |
1417300120 | Michelle Cutrell | Licensed Practical Nurse | 6294 State Highway 154, Sesser, IL 62884-2163 | 2016-07-18 |
1881045110 | Patrick B Cameron | Dentist | 6294 State Highway 154, Sesser, IL 62884-2163 | 2016-06-28 |
1285081224 | Sesser Pharmacy Si LLC | Pharmacy | 6294 State Highway 154, Suite A, Sesser, IL 62884-2163 | 2016-05-19 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1093356362 | Pamela Miller | Technician | 602 West Florence Street, Sesser, IL 62884 | 2019-10-08 |
1669459129 | Julia A Bancroft | Family Medicine | 6294 State Hwy 154, Sesser, IL 62884 | 2005-12-27 |
1669429908 | Lee Peter Bee | Neuromusculoskeletal Medicine & OMM | 107 W Franklin St, Sesser, IL 62884-1456 | 2006-05-30 |
1134530173 | Southern Illinois Medical Specialists, LLC | Independent Medical Examiner | 107 W Franklin St, Sesser, IL 62884-1456 | 2014-05-13 |
1013351667 | Southern Illinois Medical Specialists, LLC | Emergency Medicine | 107 W Franklin St, Sesser, IL 62884-1456 | 2013-04-25 |
1699011882 | Franklin Hospital District | Clinic/Center | 107 W Franklin St, Sesser, IL 62884-1456 | 2012-12-17 |
1043582760 | Rhonda Lynn Hawkins | Dental Hygienist | 115 E Franklin St, Sesser, IL 62884-1814 | 2012-01-27 |
1821128208 | Sesser Valier Cud 196 | Local Education Agency (LEA) | 4626 State Highway 154, Sesser, IL 62884-2277 | 2007-03-06 |
Taxonomy Code | 363AS0400X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Surgical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1477169522 | Priority Assist Pllc | Physician Assistant | 48 Glenda Ln, Plano, IL 60545-9652 | 2020-09-23 |
1154944478 | Diana Goldak | Physician Assistant | 3855 N Parkway Dr Apt 3a, Northbrook, IL 60062-7218 | 2020-05-20 |
1033742580 | Colleen Courtney | Physician Assistant | 218 S Driftwood Trl, Mchenry, IL 60050-5454 | 2020-02-12 |
1326678962 | Nina Kodros | Physician Assistant | 301 Madison St Ste 280, Joliet, IL 60435-6672 | 2020-01-23 |
1689218190 | Jennifer Richman | Physician Assistant | 1890 Silver Cross Blvd Ste 410, New Lenox, IL 60451-9547 | 2019-10-29 |
1710547625 | Nadia Khan | Physician Assistant | 4543 N Malden St Apt 1s, Chicago, IL 60640-5687 | 2019-06-13 |
1962065516 | Jorge Mantilla | Physician Assistant | 5540 N Kimball Ave Apt 3e, Chicago, IL 60625-4674 | 2019-04-18 |
1013479955 | Leah Rae Prager | Physician Assistant | 4400 W. 95th St., Attn: Pediatric General Surgery, Oak Lawn, IL 60453 | 2019-04-01 |
1770041949 | Laura Ann Ryan | Physician Assistant | 840 S Wood St Ste 417, Chicago, IL 60612-4325 | 2019-03-06 |
1548739782 | Helen Finke | Physician Assistant | 880 W Central Rd Ste 3300, Arlington Heights, IL 60005-2366 | 2018-11-16 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.