Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1972310035 Individual Practitioner Female Practitioner

Ivy Lewis Lewis , LPN

Licensed Practical Nurse • Chubbuck, ID

Professional Overview & Biography Verified Profile Summary

Ivy Lewis, LPN is a registered healthcare professional specializing in Licensed Practical Nurse in Chubbuck, ID. Practice services are available at 4414 DEER AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4414 Deer Ave

Chubbuck, ID 832022668

Telephone 2083173364

Specialty Benchmarks & Practice Insights

Comparative analytics for Licensed Practical Nurse in Chubbuck, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Chubbuck, ID (93 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-12-12
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

State License ID 14873

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Secondary Practice Locations

1449 Paramount St

Pocatello, ID 832013019

Phone: 2083173364

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

1 Associated Practitioners
Robert Lewis , LCSW

Social Worker - Clinical

NPI 1588471635

Licensed Clinical Social Worker

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active December 12, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location December 12, 2024

Registered at 4414 DEER AVE, CHUBBUCK, ID 832022668 (Tel: 2083173364)

📍
Updated Business Mailing Address December 12, 2024

Registered at 2293 JACQUELINE LN, POCATELLO, ID 832011867 (Tel: 2083173364)

👤
Provider Name / Credentials Updated December 12, 2024

Recorded as IVY LEWIS, LPN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 12, 2024

Licensed Practical Nurse (License #14873 in ID)

🟢
Initial NPI Registration & Enumeration December 12, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1972310035
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 12, 2024
Last Update: December 12, 2024
Sole Proprietor: No

Mailing Address

2293 Jacqueline Ln

Pocatello, ID 832011867

Phone: 2083173364

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.