TIMOTHY NATHAN LEWIS
NPI 1629673314
Counselor - Professional in Rockford, IL

Q: What is Timothy Lewis's NPI number?

The NPI number for Timothy Lewis is 1629673314. It was assigned to this individual provider in the NPPES registry on December 1, 2020.

Q: What is Timothy Lewis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Timothy Lewis was last updated on May 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 01, 2020PECOS EnrolledAccepts Medicare Assignment

695 N PERRYVILLE RD STE 4, ROCKFORD, IL 61107(779) 368-0060(815) 977-4892 Get Directions Write a Review

NPPES record last updated: May 23, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 23, 2023, Dec 1, 2020 (2 updates tracked since 2020).

On this page

About Timothy Nathan Lewis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY NATHAN LEWIS (NPI 1629673314) is an individual professional provider in Rockford, Illinois, licensed in Illinois (180015275) and active in the NPI registry since December 2020. He is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1629673314

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameTIMOTHY NATHAN LEWIS

Location Address695 N PERRYVILLE RD STE 4Rockford, IL 61107-6225

Mailing Address695 N Perryville Rd Ste 4Rockford, IL 61107-6225 · (779) 368-0060 · Fax (815) 977-4892

Phone(779) 368-0060

Fax(815) 977-4892

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateDecember 1, 2020

Last NPPES UpdateMay 23, 20232 updates tracked since enumeration

NPPES CertifiedMay 23, 2023

✔ NPI 1629673314 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

Licenses✔ Licensed in IL · 180015275✔ Licensed in IL · 178016413

695 N PERRYVILLE RD STE 4, Rockford, IL 61107

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Timothy Nathan Lewis is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1850734328

PECOS Enrollment IDI20240212003193

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMA SHACKLETON LCPC

Counselor (Professional)