Active NPI
Jacqueline Rose Lewy
- Student in an Organized Health Care Education/Training Program
- Atlanta, GA
National Provider Identifier
1043079346
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049 - Phone
- (404) 778-7777
- NPI assigned
- Mar 18, 2024
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
49 Jesse Hill Jr Dr SE
Atlanta, GA 30303-3049
Mailing address
212 Hedgerose LN
Hopkinton, NH 03229-2030
Phone (603) 856-1912
Other practice location 1
1365 Clifton Rd NE Bldg C
Atlanta, GA 30322-1013
Phone (404) 778-1900
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240521004462 | GA | Order and Referring Only - Internal Medicine | 4789026840 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710720000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1710720000000",
"number": "1043079346",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "212 HEDGEROSE LN",
"city": "HOPKINTON",
"state": "NH",
"postal_code": "032292030",
"telephone_number": "603-856-1912"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 JESSE HILL JR DR SE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303033049",
"telephone_number": "404-778-7777"
}
],
"practiceLocations": [
{
"address_1": "1365 Clifton Rd NE Bldg C",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221013",
"country_code": "US",
"telephone_number": "404-778-1900",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWY",
"first_name": "JACQUELINE",
"middle_name": "ROSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-03-18",
"last_updated": "2024-03-18",
"certification_date": "2024-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.