Kelly Jo Lewis, NURSE PRACTITIONER
NPI 1104389451ActiveIndividual· Nurse Practitioner, Primary Care· Kingman, AZ
Nurse Practitioner, Primary Care (NURSE PRACTITIONER) in Kingman, Arizona, licensed in AZ, with an NPI issued in April 2019. Part D covered 67 prescriptions written in 2024, 88% of them generic. Lists Kingman Regional Medical Center as a hospital affiliation.
Overview
| NPI | 1104389451 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NURSE PRACTITIONER |
| Sole proprietor | No |
| NPI issued | Apr 12, 2019 |
| Last updated in NPPES | May 1, 2026 |
| Certified by provider | May 1, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Primary Care Primary | 363LP2300X | 307837 | AZ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (AZ) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 67 · 167 30-day fills |
|---|---|
| Patients | 32 |
| Total drug cost | $7,904 |
| Generic share | 88% of claims |
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Hospital affiliation
- Kingman Regional Medical CenterKingman, AZ
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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