MR. PHILLIP E LEWELLEN (NPI# 1134110356) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134110356 |
| Entity Type | Individual |
| Full Name | MR. PHILLIP E LEWELLEN |
| Credential | PA |
| Practice Address |
1995 E Oakland Park Blvd Ft Lauderdale FL 33306-1147 |
| Mailing Address |
2011 Murphy Ave Suite 408 Nashville TN 37203-2023 |
| Practice Telephone | 9547916146 |
| Practice Fax Number | 9543372733 |
| Mailing Telephone | 6153271515 |
| Mailing Fax Number | 6153521428 |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2019-03-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
551 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
551 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS | 4071394 | 01 |
| TN | 3666998 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2011 Murphy Ave, Suite 408, Nashville, TN 372032023 | 6153271515 | 6153521428 |
| Street Address |
1995 E OAKLAND PARK BLVD |
| City | FT LAUDERDALE |
| State | FL |
| Zip Code | 33306-1147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568684223 | Amber Hickman Pettis | Counselor | 1995 E Oakland Park Blvd, Suite 350, Ft Lauderdale, FL 33306-1147 | 2007-05-03 |
| 1992729685 | John Tobias Gray | Physician Assistant | 1995 E Oakland Park Blvd, Suite 250, Ft Lauderdale, FL 33306-1147 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568927705 | Peaceful Prana Therapy, LLC | Social Worker | 2300 E Oakland Pk Blvd, Ste 206, Plantation, FL 33306 | 2019-02-01 |
| 1215429717 | Pain Treatment Specialists | Pain Medicine | 2601 E Oakland Park Blvd Ste 200, Fort Lauderdale, FL 33306 | 2018-05-31 |
| 1740779735 | Complete Family Dentistry, LLC | Dentist | 3015 Bayview Drive Suite B, Fort Lauderdale, FL 33306 | 2018-05-04 |
| 1104281856 | Raiselle Gittler | Massage Therapist | 4640 E Federal Hwy, Suite F, Fort Lauderdale, FL 33306 | 2015-12-23 |
| 1952703308 | Joseph Carlo Pastura | Dentist | 3051 N. Federal Hwy, Ft. Lauderdale, FL 33306 | 2014-09-17 |
| 1679857247 | Massage Therapy By Rina Richard Inc. | Massage Therapist | 2881 East Oakland Park Blvd. Ste # 113, Fort Lauderdale, FL 33306 | 2011-09-30 |
| 1467757393 | Paramount Wellness Group LLC | Chiropractor | 2745 E. Oakland Park Blvd., Fort Lauderdale, FL 33306 | 2011-01-25 |
| 1679800684 | Marcia Lynne Sills | Internal Medicine | 2741 Ne 34th Street, Fort Lauderdale, FL 33306 | 2009-11-11 |
| 1518133479 | Christopher M Schloss | Dentist | 2916 Bayview Drive, Fort Lauderdale, FL 33306 | 2008-05-01 |
| 1497926687 | Glenn Ross Caddy | Psychologist | 3101 North Federal Highway, Suite 301, Ft. Lauderdale, FL 33306 | 2008-03-17 |
| Find all providers in zip 33306 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396822573 | Susan O Simonton | Physician Assistant | 2500 E Las Olas Blvd, #1504, Ft Lauderdale, FL 33301-1508 | 2006-11-01 |
| 1265083976 | Matthew Paul Williams | Physician Assistant | 1995 E Oakland Park Blvd Ste 250, Ft Lauderdale, FL 33306-1149 | 2019-09-24 |
| 1528456548 | Florida Practitioners, LLC | Physician Assistant | 1995 E Oakland Park Blvd Ste 250, Ft Lauderdale, FL 33306-1149 | 2014-12-29 |
| 1003040932 | 1st Assist of South Florida LLC | Physician Assistant | 4725 N Federal Hwy, Ft Lauderdale, FL 33308-4603 | 2009-05-06 |
| 1194969923 | Theresa Anne Eichinger | Physician Assistant | 1995 E Oakland Park Blvd Ste 250, Ft Lauderdale, FL 33306-1149 | 2009-04-23 |
| 1871765081 | William Bresnihan | Physician Assistant | 608 Se 6th St, Ft Lauderdale, FL 33301-3418 | 2008-03-27 |
| 1215129622 | Luciano John Radi | Physician Assistant | 6550 N Federal Hwy, Ste 512, Ft Lauderdale, FL 33308-1404 | 2007-08-10 |
| 1033275854 | Joseph E Campbell | Physician Assistant | 6550 N Federal Hwy, Suite 512, Ft Lauderdale, FL 33308-1404 | 2006-12-28 |
| 1194738641 | Julio Beltran | Physician Assistant | 6550 N Federal Hwy, Suite 512, Ft Lauderdale, FL 33308-1404 | 2006-08-15 |
| 1871501981 | Felix Armando Gonzalez-quevedo | Physician Assistant | 6550 N Federal Hwy, Suite 512, Ft Lauderdale, FL 33308-1404 | 2006-08-04 |
| Find all providers in FT LAUDERDALE | ||||
| City | FT LAUDERDALE |
| Zip Code | 33306 |
Please comment or provide details below to improve the information on MR. PHILLIP E LEWELLEN.
| 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.