Provider Demographics
NPI:1629449301
Name:LEWIS, EMILY KEMP (DPT)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KEMP
Last Name:LEWIS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:
Other - Last Name:KEMP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:350 RADIO PARK DR STE 1
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-2998
Mailing Address - Country:US
Mailing Address - Phone:859-625-5986
Mailing Address - Fax:859-625-5987
Practice Address - Street 1:350 RADIO PARK DR STE 1
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-2998
Practice Address - Country:US
Practice Address - Phone:859-625-5986
Practice Address - Fax:859-625-5987
Is Sole Proprietor?:No
Enumeration Date:2015-10-07
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0066622251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100419050Medicaid