RUSSELL LEWIS JR. (NPI# 1255367025) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255367025 |
| Entity Type | Individual |
| Full Name | RUSSELL LEWIS JR. |
| Credential | MD |
| Practice Address |
190 Grand Seasons Dr Waupaca WI 54981-8219 |
| Mailing Address |
900 Illinois Avenue Stevens Point WI 54481 |
| Practice Telephone | 7152583650 |
| Practice Fax Number | 7152585749 |
| Mailing Telephone | 7153465000 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2008-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4937420 | WI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 34867900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700279197 | Russell G. Lewis | Dentist | 1434 E. 9400 S. Ste 201, Sandy, UT 84093 | 2015-03-10 |
| 1417955592 | Russell A Lewis | Contractor | 108 Katie Dr, Rincon, GA 31326-5708 | 2005-07-12 |
| 1104273382 | Russell Shepherd Lewis Jr. | Student in an Organized Health Care Education/Training Program | 15 York St, Ynhh Dept of Medicine, Lmp 1092, New Haven, CT 06510-3221 | 2016-05-18 |
| Street Address |
190 GRAND SEASONS DR |
| City | WAUPACA |
| State | WI |
| Zip Code | 54981-8219 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790286342 | Christa Jeanne Hemmila | Nurse Practitioner | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 | 2018-02-27 |
| 1235512310 | Carri Lynn Schacherl | Nurse Practitioner | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 | 2015-07-07 |
| 1790830883 | Judith L Mcallister | Nurse Practitioner | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 | 2007-01-25 |
| 1558416644 | Joseph D Mccausland IIi | Internal Medicine | 190 Grand Seasons Dr, Waupaca, WI 54981 | 2007-01-25 |
| 1275622524 | Teresa Lee Taylor | Counselor | 190 Grand Seasons Dr, Waupaca, WI 54981-8219 | 2006-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366096141 | Renee Elizabeth Winn | Speech-Language Pathologist | 800 Riverside Drive Dr. 902 Building, Speech Therapy, Waupaca, WI 54981 | 2019-07-30 |
| 1891263216 | Stephanie Rice | Dental Hygienist | N4008 Morgan Dr, Waupaca, WI 54981 | 2018-11-03 |
| 1972092989 | Renew Physical Therapy and Wellness, LLC | Physical Therapist | N2919 County Road Qq, Waupaca, WI 54981 | 2018-05-04 |
| 1366942195 | Lanna Boyle | Physical Medicine & Rehabilitation | E1132 Hillcrest Dr, Waupaca, WI 54981 | 2018-02-19 |
| 1710333893 | Thedacare Medical Center - Waupaca, Inc. | General Acute Care Hospital | N2610 Wi 22, Waupaca, WI 54981 | 2016-05-09 |
| 1750743365 | Kimberly Marie Kraeger | Counselor | Waupaca County Dhhs, 811 Harding St, Waupaca, WI 54981 | 2016-03-23 |
| 1619211596 | Kari Anna Esbensen | Counselor | N2919 Cty Qq, Waupaca, WI 54981 | 2012-11-16 |
| 1396027629 | Roots Wholistic Health | Chiropractor | 717 Churchill St., Waupaca, WI 54981 | 2011-09-13 |
| 1629387006 | Barton Jerome Blum | General Practice | E1803 Melody Lane, Waupaca, WI 54981 | 2010-10-01 |
| 1710219357 | Anne Marie Collins-reed | Social Worker | 315 River Road, New London, WI 54981 | 2010-02-08 |
| Find all providers in zip 54981 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720144876 | Robert Lester Peterson | Family Medicine | 900 Riverside Dr, Suite IIi, Waupaca, WI 54981-1983 | 2006-12-30 |
| 1396731410 | Michelle A Soto | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2005-09-23 |
| 1669906004 | Ezra Lyon | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2017-04-12 |
| 1073932331 | Ashley Tardieu | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2014-04-15 |
| 1457619348 | James P Spencer | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2012-04-27 |
| 1144547027 | Dorrie Marie Happ | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2010-04-30 |
| 1649597501 | Zachary J Baeseman | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2010-04-30 |
| 1063535706 | Robert L. Peterson, M.d., S.c. | Family Medicine | 900 Riverside Dr, Suite IIi, Waupaca, WI 54981-1983 | 2007-04-09 |
| 1235291048 | Patty Kile | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2006-12-15 |
| 1649288093 | Robert Dent | Family Medicine | 710 Riverside Dr, Waupaca, WI 54981-1941 | 2006-08-03 |
| Find all providers in WAUPACA | ||||
Please comment or provide details below to improve the information on RUSSELL LEWIS JR..
| 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.