Jacob Dwayne Lewis

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Practice address

8179 Trace CT
Riverdale, GA 30274-4318

Phone

(470) 634-2692

NPI assigned

Apr 25, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Time Efficient Courier & Logistics LLC

  • Non-emergency Medical Transport (VAN)
  • Atlanta, GA
  • NPI 1336992866
  NPD Authorized official

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

{
    "created_epoch": "1714003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714348800000",
    "number": "1124874607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W PEACHTREE ST NW STE 2625",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303093499",
            "telephone_number": "470-634-2692",
            "fax_number": "888-816-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8179 TRACE CT",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744318",
            "telephone_number": "470-634-2692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JACOB",
        "middle_name": "DWAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-29",
        "certification_date": "2024-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Legacy Primary Care and Wellness
• Khemaporn Lertdetkajorn, MD
• Rodney Fitzgerald Lester Jr.
• Jennifer Leverett, PHARM.D.
• Brittany Lewis
• Lexok Consulting
• Paul Harvey Liebman, M.D.
• Life Changers Community Empowerment Enterprises, Inc
• Life Cycle OB/GYN, LLC
• Life Cycle OB/GYN, LLC

• Non-emergency Medical Transport (VAN) in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Non-emergency Medical Transport (VAN) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2024; 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.