MIJANOU D MARRETTA-LEWIS (FNP-C) – Family Nurse Practitioner, NPI 1235627142

MIJANOU D MARRETTA-LEWIS (FNP-C) is a healthcare provider. based in Centerville, Ohio. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. APRN.CNP.022588 (OH). The NPI Number for MIJANOU D MARRETTA-LEWIS (FNP-C) is 1235627142

Main info

Female
Sole Proprietor
9 Years Of Experience
Accepts Medicare Assignment
Name
MIJANOU D MARRETTA-LEWIS (FNP-C)
NPI
1235627142
Phone
(937) 434-7353
Address
1989 MIAMISBURG CENTERVILLE RD STE 301
Enumeration Date
26 April 2018
Last Update Date
17 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9374347353
Graduation Year
2017 (9 years ago)
PAC ID
7113281544
Group Practice PAC ID
2860386349
Professional Enrollment ID
I20180510001013
Address ID
OH454593858CE1989XRDXX407
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience40
Completeness85
Years active:8State licenses:1Digital endpointsOther names

14,984 NURSE PRACTITIONER in OH

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Provider Addresses for MIJANOU D MARRETTA-LEWIS (FNP-C)

  • 1989 MIAMISBURG CENTERVILLE RD STE 301

    CENTERVILLE, OH 454593858

    Phone: (937) 434-7353

    Fax: (937) 438-6569

    Type: Mailing

  • Miamisburg Centerville Road, Centerville, Montgomery County, Ohio, 45459-4011, United States

    CENTERVILLE, OH 454593858

    Phone: (937) 434-7353

    Fax: (937) 438-6569

    Type: Location

  • 685, Wright Street, Yellow Springs, Greene County, Ohio, 45387, United States

    YELLOW SPRINGS, OH 453871441

    Phone: (937) 450-0622

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $15.

Total Amount is formed as General ($15) + Research ($0) + Ownership ($0) = $15.

Last reported payment date: 2024-01-23 • Largest payer in this snapshot: ABBVIE INC. ($15).

Total Amount

$15

General + Research + Ownership

Payments

1

Total payment records

General Amount

$15

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-23

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ABBVIE INC.$15
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2018-05-10

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20180510001013INurse PractitionerOHTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 45459)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860386349View full group profile
NameSpecialtyState
Family PracticeOH
Family PracticeSC
Nurse PractitionerOH
-OH
Nurse PractitionerOH
-OH
Nurse PractitionerOH
Rheumatology, Internal MedicineOH
Nurse PractitionerOH
Family PracticeOH

Reviews

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Frequently asked questions

Is MIJANOU D MARRETTA-LEWIS (FNP-C) listed with a National Provider Identifier?
Yes — MIJANOU D MARRETTA-LEWIS (FNP-C) has NPI 1235627142 on file in the registry.
Is there an active status for MIJANOU D MARRETTA-LEWIS (FNP-C)?
For scheduling context, MIJANOU D MARRETTA-LEWIS (FNP-C) is shown as active in the registry.
What expertise is attributed to MIJANOU D MARRETTA-LEWIS (FNP-C)?
MIJANOU D MARRETTA-LEWIS (FNP-C)'s specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What practice footprint exists for MIJANOU D MARRETTA-LEWIS (FNP-C)?
Travel planning: use Centerville, Ohio as the reference point for MIJANOU D MARRETTA-LEWIS (FNP-C), then confirm.
When was this NPI issued?
Enumeration for MIJANOU D MARRETTA-LEWIS (FNP-C) is noted as April 26, 2018 where the registry provides it.

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