1467509760 NPI number — DR. DAWNA E LEWIS PH.D.

Table of content: DR. DAWNA E LEWIS PH.D. (NPI 1467509760)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467509760 NPI number — DR. DAWNA E LEWIS PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEWIS
Provider First Name:
DAWNA
Provider Middle Name:
E
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
JOHNSON
Provider Other First Name:
DAWNA
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467509760
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 N 30TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OMAHA
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68131-2136
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-280-8100
Provider Business Mailing Address Fax Number:
402-280-8103

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 N 30TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OMAHA
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68131-2136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-498-6540
Provider Business Practice Location Address Fax Number:
402-498-6357
Provider Enumeration Date:
01/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 231H00000X , with the licence number:  71 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2585547 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3585547 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36822 . This is a "BCBS BT" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 1585547 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 36823 . This is a "BCBS ENT" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 8582825 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0585547 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".




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