Individual provider Active NPI

Marcia Lynn Lewis, PHD

  • Clinical Psychologist
  • Columbia, SC
National Provider Identifier
1104994706
Registry record updated Aug 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
1113 Issued in SC
Practice address
223 Stoneridge Dr
Palmetto Health Baptist Pain and Orthopaedics
Columbia, SC 29210-8049
Phone
(803) 296-7246
Fax
(803) 296-2400
NPI assigned
Dec 1, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 1113 SC Primary

Addresses

Primary practice location

223 Stoneridge Dr
Palmetto Health Baptist Pain and Orthopaedics
Columbia, SC 29210-8049

Mailing address

223 Stoneridge Dr
Columbia, SC 29210-8049
Phone (803) 296-2431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140213001313 MO Practitioner - Clinical Psychologist 7719026863 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1129 Macklind Ave
Saint Louis, MO 63110-1440
Phone 3145340200415

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4761OHMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Psychological Services, Inc. Clinical PastSince Oct 1, 1998 Accepting new patients
Rehabilitation Institute of Virginia Inc Past Accepting new patients

Organizations & group practices 3

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": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250640000000",
    "number": "1104994706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 STONERIDGE DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108049",
            "telephone_number": "803-296-2431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 STONERIDGE DR",
            "address_2": "PALMETTO HEALTH BAPTIST PAIN AND ORTHOPAEDICS",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292108049",
            "telephone_number": "803-296-7246",
            "fax_number": "803-296-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARCIA",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-01",
        "last_updated": "2009-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.