ROGER A LEWIS NPI 1508981291

NPI Information

  • NPI: 1508981291
  • Provider Name: ROGER A LEWIS
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: CRANBERRY MEDICAL CLINIC
  • CLIA Number: 51D0662831
  • Address: 603B W STATE AVE
    TERRA ALTA, WV
    ZIP 26764
  • Phone: (304) 789-2457

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NPI Details

ROGER A LEWIS is a family medicine in Terra Alta, WV. The provider is 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. ROGER A LEWIS NPI is 1508981291. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Cranberry Medical Clinic.

The provider's business location address is:

603B W STATE AVE
TERRA ALTA, WV
ZIP 26764-223
Phone: (304) 789-2457
Fax: (304) 789-6812

The provider's authorized official is Norma Keim .
The authorized official title is Office Manager and has the following contact phone number (304) 789-2457.

The CLIA number assigned to this NPI record is 51D0662831 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/20/2007 and was last updated on 2/8/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine12705WEST VIRGINIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
19337321MEDICARE ID-TYPE UNSPECIFIEDWEST VIRGINIAMEDICARE GROUP
20201807000MEDICAIDWEST VIRGINIA
3CM7276OTHERWEST VIRGINIAMEDICARE RAILROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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