Wallace E Lewis, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101028388 Issued in VA

Practice address

18682 Northumberland Hwy
Reedville, VA 22539-3411

Phone

(804) 453-4537

Fax

(804) 453-4713

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

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.

• Chesapeake Medical Group

  • Family Medicine Physician
  • Reedville, VA
  • NPI 1700100583

  Family Medicine

  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 8, 2013.

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357603200000",
    "number": "1114981966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1328",
            "city": "KILMARNOCK",
            "state": "VA",
            "postal_code": "224821328",
            "telephone_number": "804-435-8570",
            "fax_number": "804-435-8037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18682 NORTHUMBERLAND HWY",
            "city": "REEDVILLE",
            "state": "VA",
            "postal_code": "225393411",
            "telephone_number": "804-453-4537",
            "fax_number": "804-453-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "WALLACE",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2013-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101028388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "080133503",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1114981966",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chesapeake Medical Group
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• Patricia A Fulcher
• Nancy Lee Holzshu
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• Laura Jean Reier, RPH
• Superior Home Medical Equipment, LLC
• Sandra Dee Zeiler, MPT

• All providers in Reedville, VA
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2013; 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.