Active NPI
Shanelle Lewis
- Phlebotomy Technician
- Decatur, GA
National Provider Identifier
1003392259
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebotomy Technician
- Practice address
- 4484 Covington Hwy
Decatur, GA 30035 - Phone
- (347) 313-2205
- NPI assigned
- Jul 11, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Laboratory Management Specialist/Technologist | 246QL0900X | |||
| Phlebotomy Technician | 246RP1900X | Primary |
Addresses
Primary practice location
4484 Covington Hwy
Decatur, GA 30035
Mailing address
5910 Shadow Rock Dr
Lithonia, GA 30058-3232
Phone (347) 313-2205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | NA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myorganics | Laboratory Management | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531267200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531440000000",
"number": "1003392259",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5910 SHADOW ROCK DR",
"city": "LITHONIA",
"state": "GA",
"postal_code": "300583232",
"telephone_number": "347-313-2205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4484 COVINGTON HWY",
"city": "DECATUR",
"state": "GA",
"postal_code": "30035",
"telephone_number": "347-313-2205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "SHANELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-07-11",
"last_updated": "2018-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "246QL0900X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Pathology, Laboratory Management",
"state": null,
"license": null,
"primary": false
},
{
"code": "246RP1900X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Phlebotomy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NA",
"identifier": "NA",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Decatur, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.