Individual provider Active NPI

Jerona Alysse Lewis, MD

  • Family Medicine Physician
  • Charlotte, NC
National Provider Identifier
1063687747
Registry record updated Jul 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2011-00337 Issued in NC
Practice address
10620 Park Rd
Ste 202
Charlotte, NC 28210-8472
Phone
(704) 667-0920
NPI assigned
Apr 24, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2011-00337 NC Primary

Addresses

Primary practice location

10620 Park Rd
Ste 202
Charlotte, NC 28210-8472

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jlewis2893257@CarolinasHealthcareSystem.direct-ci.com Atrium Health
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, AL, GA3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20110915000676 NC Practitioner - Family Practice 0042481491 Reassigns benefits to 1 organization
I20250102000131 AL Practitioner - Family Practice 0042481491 Reassigns benefits to 1 organization
I20250102000183 GA Practitioner - Family Practice 0042481491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wake Forest University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians
Floyd Healthcare Management IncGroup PAC ID 5193633386, 133 clinicians

Practice addresses (Care Compare)

10620 Park Rd
Suite 202
Charlotte, NC 28210-0106
Phone (704) 667-0920

400 Northwodd Dr
Centre, AL 35960-1023
Phone (256) 927-5531

990 Veterans Memorial Hwy NE
Suite a
Rome, GA 30161-4938
Phone (706) 291-4100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2011-00337NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince Jun 24, 2024 Accepting new patients
Floyd Healthcare Management Inc CurrentSince Dec 1, 2024 Accepting new patients
Floyd Healthcare Management Inc Family Medicine CurrentSince Dec 1, 2024 Accepting new patients
Carolinas Physicians Network, Inc Family Medicine CurrentSince Jun 24, 2024 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients
Floyd Cherokee Medical Center LLC Current Accepting new patients

Locations

400 Northwood Dr
Centre, AL 35960
Phone (256) 927-1382

1025 N Main St
Cedartown, GA 30125
Phone (770) 748-5212

420 E 2nd Ave
Ste 103
Rome, GA 30161
Phone (706) 509-3278

990 Veterans Memorial Hwy NE
#A
Rome, GA 30161
Phone (706) 291-4100

100 N 6th St
Ste 900A
Minneapolis, MN 55403

14214 Ballantyne Lake Rd
Ste 100
Charlotte, NC 28277
Phone (704) 667-2650

1801 Rozzelles Ferry Rd
Charlotte, NC 28208
Phone (704) 446-9987

10620 Park Rd
Ste 202
Charlotte, NC 28210
Phone (704) 512-3988

Interoperability endpoints

  • Direct secure messaging: jlewis197511@direct.novanthealth.org
  • Direct secure messaging: jlewis2893257@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 6

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": "1208995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721001600000",
    "number": "1063687747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10620 PARK RD",
            "address_2": "STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108472",
            "telephone_number": "704-667-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JERONA",
        "middle_name": "ALYSSE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-24",
        "last_updated": "2024-07-15",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2011-00337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlewis2893257@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "10620 Park Rd",
            "address_2": "Ste 202",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282108472",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.