Individual provider Active NPI

Austin J Lewis, MD

  • Surgery Physician
  • Carrollton, GA
National Provider Identifier
1003256983
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
080683 Issued in GA
Practice address
157 Clinic Ave Ste 302
Carrollton, GA 30117
Phone
(770) 834-3336
Fax
(770) 832-2331
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 080683 GA Primary

Addresses

Primary practice location

157 Clinic Ave Ste 302
Carrollton, GA 30117

Mailing address

706 Dixie St Ste 220
Carrollton, GA 30117-3858
Phone (770) 838-8710

Other practice location 1

1924 Alcoa Hwy # U-11
Knoxville, TN 37920-1511
Phone (865) 305-9230

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180927000449 GA Practitioner - General Surgery 5698919389 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Georgia School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

157 Clinic Ave
Suite 302B
Carrollton, GA 30117-4454
Phone (770) 812-5902

Hospital & facility affiliations

  • Tanner Home Health Services Home health agency, Carrollton, GA, CCN 117319
  • Tanner Medical Center - Carrollton Hospital, Carrollton, GA, CCN 110011
  • Tanner Medical Center Villa Rica Hospital, Villa Rica, GA, CCN 110015

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
080683GAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc CurrentSince Aug 13, 2018 Accepting new patients
TMC Children'S Healthcare of West Georgia Past Accepting new patients
Tanner Medical Center, Inc Past Accepting new patients

Locations

119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710

157 Clinic Ave
Ste 302B
Carrollton, GA 30117
Phone (770) 812-5902

157 Clinic Ave
Ste 302
Carrollton, GA 30117
Phone (770) 812-5902

706 Dixie St
Ste 220
Carrollton, GA 30117
Phone (770) 812-8825

157 Clinic Ave
Ste 302C
Carrollton, GA 30117
Phone (770) 834-3336

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1003256983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 DIXIE ST STE 220",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173858",
            "telephone_number": "770-838-8710",
            "fax_number": "770-812-5735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "157 CLINIC AVE STE 302",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "30117",
            "telephone_number": "770-834-3336",
            "fax_number": "770-832-2331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1924 Alcoa Hwy # U-11",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201511",
            "country_code": "US",
            "telephone_number": "865-305-9230",
            "fax_number": "865-305-8894",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "AUSTIN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "080683",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

Verify at the official NPI Registry.