Active NPI
David R. Lewis, M.A.
- Psychologist
- Barnwell, SC
National Provider Identifier
1104128313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 3080
- Practice address
- 10706 Marlboro Ave
Barnwell, SC 29812-6376 - Phone
- (803) 259-7337
- Fax
- (803) 259-9505
- NPI assigned
- Nov 19, 2010
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 3080 | SC | Primary |
Addresses
Primary practice location
10706 Marlboro Ave
Barnwell, SC 29812-6376
Mailing address
10706 Marlboro Ave
Barnwell, SC 29812-6376
Phone (803) 259-7337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RHC004 | Medicaid | SC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3080 | SC | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290124800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290124800000",
"number": "1104128313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10706 MARLBORO AVE",
"city": "BARNWELL",
"state": "SC",
"postal_code": "298126376",
"telephone_number": "803-259-7337",
"fax_number": "803-259-9505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10706 MARLBORO AVE",
"city": "BARNWELL",
"state": "SC",
"postal_code": "298126376",
"telephone_number": "803-259-7337",
"fax_number": "803-259-9505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "DAVID",
"middle_name": "R.",
"name_prefix": "Mr.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-19",
"last_updated": "2010-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "3080",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "RHC004",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Barnwell, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.