Shantell Denise Lewis, MS CCCA FAAA

Primary specialty

AudiologistTaxonomy code 231H00000X

License

2201001199 Issued in VA

Practice address

620 Moorefield Park Drive Suite 100
Virginia Professional Hearing Healthcare Center
Richmond, VA 23236

Phone

(804) 330-1350

NPI assigned

Apr 17, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Advanced Otolaryngology PC

  • Specialist
  • Richmond, VA
  • NPI 1194779215
  NPD (past)

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

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300147200000",
    "number": "1063686384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 MOOREFIELD PARK DR STE 100",
            "address_2": "VIRGINIA PROFESSIONAL HEARING HEALTH CENTER",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232363692",
            "telephone_number": "804-330-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 MOOREFIELD PARK DRIVE SUITE 100",
            "address_2": "VIRGINIA PROFESSIONAL HEARING HEALTHCARE CENTER",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23236",
            "telephone_number": "804-330-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SHANTELL",
        "middle_name": "DENISE",
        "name_prefix": "Ms.",
        "credential": "MS CCCA FAAA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2011-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "VA",
            "license": "2201001199",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "VA",
            "license": "2101001651",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phylicia Lewis
• Richard G Lewis, MD
• Sandra Ellen Lewis, CRNA
• Schliqua P Lewis, LPC
• Shanel Lewis
• Shantelle Latris Lewis, PHARM D
• Shawn W. Lewis, AGPCNP-BC
• Shayonna Lewis
• Steven J. Lewis, M.D.
• Troy Maurice William Lewis, NP

• Audiologist in Richmond, VA
• Providers in Richmond, VA by specialty
• Audiologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.