JARED MICHAEL LEWIS (NPI# 1639611718) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639611718 |
| Entity Type | Individual |
| Full Name | JARED MICHAEL LEWIS |
| Credential | PA C |
| Practice Address |
1723 Broadway St Suite 410 Cape Girardeau MO 63701-4566 |
| Practice Telephone | 5733327746 |
| Practice Fax Number | 5733399709 |
| Mailing Telephone | 5733327746 |
| Mailing Fax Number | 5733399709 |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2016-11-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
2016039248 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912295650 | Jared S Lewis | Physical Therapist | 840 Winter St, Attn: Pro Sports Therapy, Waltham, MA 02451-1433 | 2011-07-15 |
| Street Address |
1723 BROADWAY ST SUITE 410 |
| City | CAPE GIRARDEAU |
| State | MO |
| Zip Code | 63701-4566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801893979 | Pairote Jaroonwanichkul | Internal Medicine | 1723 Broadway St, Suite 315, Cape Girardeau, MO 63701-4505 | 2005-07-05 |
| 1043768088 | Tyler Joshua Greenwood | Physician Assistant | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2016-09-20 |
| 1275880429 | Jacob Louis Muckerman | Nurse Practitioner | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2012-08-07 |
| 1003115536 | Gladys Grace Tiwonge Kamanga-sollo | Physical Medicine & Rehabilitation | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2011-03-23 |
| 1780982215 | Southeast Missouri Hospital Physicians LLC | Clinic/Center | 1723 Broadway St, Suite 205, Cape Girardeau, MO 63701-4566 | 2011-03-08 |
| 1679876767 | Magin Lea Chapman | Nurse Practitioner | 1723 Broadway St, Cape Girardeau, MO 63701-4566 | 2010-12-10 |
| 1821398678 | Andrew N Garner | Clinical Nurse Specialist | 1723 Broadway St, Cape Girardeau, MO 63701-4566 | 2010-10-27 |
| 1013222983 | Michele L Tanz | Nurse Practitioner | 1723 Broadway St, Suite 220, Cape Girardeau, MO 63701-4566 | 2010-08-16 |
| 1396066734 | Stephanie Lee Riley | Nurse Practitioner | 1723 Broadway St, Ste 410, Cape Girardeau, MO 63701-4566 | 2010-06-21 |
| 1407084890 | Jennifer Marie Lovegreen | Obstetrics & Gynecology | 1723 Broadway St, Suite 315, Cape Girardeau, MO 63701-4566 | 2009-06-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336748110 | Westbrook Dialysis, LLC | Clinic/Center | 140 West Drive, Cape Girardeau, MO 63701 | 2020-10-22 |
| 1972079580 | Savannah Laine Menard | Behavior Technician | 20 S. Sprigg St, Cape Girardeau, MO 63701 | 2018-10-22 |
| 1932690377 | Broadway Specialty, LLC | Pharmacy | 706 Broadway St, Cape Girardeau, MO 63701 | 2018-05-22 |
| 1356864649 | Terri L. Mccord | Pharmacist | 4170 Connor Dr, Cape Girardeau, MO 63701 | 2017-07-19 |
| 1013459312 | Christina Cossou | Nurse Practitioner | 2116 Megan Dr Ste 102, Cape Girardeau, MO 63701 | 2016-11-17 |
| 1124573365 | Ashley Sullivan | Massage Therapist | 3041 Melrose Ave, Cape Girardeau, MO 63701 | 2016-08-17 |
| 1225432172 | Axpm - Merkley, LLC | Dentist | 2116 Megan Dr., Suite 101, Cape Girardeau, MO 63701 | 2014-10-21 |
| 1639573397 | Marian Perez Hurt | Physical Therapist | 2001 N. Kingshighway, Fountainbleau Lodge, Cape Girardeau, MO 63701 | 2014-10-09 |
| 1891194213 | Deanna Abner | Case Manager/Care Coordinator | 20 South Sprigg, Cape Girardeau, MO 63701 | 2014-08-21 |
| 1831506880 | Kwadwo O Britwum | Behavioral Analyst | Morningstar Behavioral Associates, 338 W. Broadway Suite 301, Cape Girardeau, MO 63701 | 2014-07-22 |
| Find all providers in zip 63701 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295257285 | Katelynn Elizabeth Austin | Physician Assistant | 3250 Gordonville Rd Ste 384, Cape Girardeau, MO 63703-5095 | 2017-07-11 |
| 1245239417 | Christopher D Moorman | Physician Assistant | 150 S Mount Auburn Rd Ste 342, Cape Girardeau, MO 63703-4911 | 2005-07-19 |
| 1043768088 | Tyler Joshua Greenwood | Physician Assistant | 1723 Broadway St, Suite 410, Cape Girardeau, MO 63701-4566 | 2016-09-20 |
| 1619354453 | Orrin D Rice | Physician Assistant | 1723 Broadway, Suite 410, Cape Girardeau, MO 63701-4556 | 2015-04-30 |
| 1427091925 | Marilyn J Jansen | Physician Assistant | 304 S Mount Auburn Rd, Cape Girardeau, MO 63703-4920 | 2006-06-13 |
| 1942259189 | Patrick O'brien Hammond | Physician Assistant | 1723 Broadway, Suite 410, Cape Girardeau, MO 63701 | 2006-05-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184259079 | Dustin Edward Hemker | Physician Assistant | 937 Blake Ct, Saint Peters, MO 63376-5527 | 2020-03-11 |
| 1730669169 | Hannah Eagleburger | Physician Assistant | 4321 Wornall Rd, Ste 530, Kansas City, MO 64111 | 2018-08-15 |
| 1770073587 | Ashton Marie Roberts | Physician Assistant | 1 Hospital Dr # Dc077.00, Columbia, MO 65212-1000 | 2018-05-16 |
| 1407214364 | Kathryn Rebecca Bachman | Physician Assistant | 226 S Woods Mill Rd Ste 35w, Chesterfield, MO 63017-3442 | 2016-02-08 |
| 1699148429 | Michael Farrell | Physician Assistant | 7827 Highway N Ste 104, O Fallon, MO 63368-6704 | 2015-11-02 |
| 1427441492 | Cornerstone First Assisting | Physician Assistant | 267 Countryshire Dr, Lake St Louis, MO 63367-5823 | 2015-03-14 |
| 1205232915 | Pa Staffing LLC | Physician Assistant | 408 Ballwin Ave, Ballwin, MO 63021-5213 | 2014-11-06 |
| 1568702090 | Jamie Lyn Mertz | Physician Assistant | 9423 N Wayne Ct, Kansas City, MO 64155-2999 | 2013-02-20 |
| 1245586536 | Jeb Medical LLC | Physician Assistant | 1215 Clay St, Kansas City, MO 64116-4026 | 2012-07-24 |
| 1477885945 | Michelle L Powell | Physician Assistant | 7827 Town Square Ave, Suite 104, O Fallon, MO 63368-6704 | 2010-02-08 |
| Find all providers with the same taxonomy | ||||
| City | CAPE GIRARDEAU |
| Zip Code | 63701 |
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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.