Individual provider Active NPI

Allison Grace Lewis, CPNP

  • Pediatric Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1225280720
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
3720 Issued in SC
Practice address
9 Richland Medical Park Dr
Suite 500
Columbia, SC 29203-6859
Phone
(803) 434-4555
Fax
(803) 434-4599
NPI assigned
Oct 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 3720 SC Primary

Addresses

Primary practice location

9 Richland Medical Park Dr
Suite 500
Columbia, SC 29203-6859

Mailing address

PO Box 743904
Atlanta, GA 30374-3904
Phone (803) 296-7320

Other identifiers 1

IdentifierTypeStateIssuer
NP1371MedicaidSC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090415000520 SC Practitioner - Nurse Practitioner 2860549557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians

Practice addresses (Care Compare)

9 Richland Medical Park Dr
Suite 505
Columbia, SC 29203-6844
Phone (803) 434-7950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3720SCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health Medical Group-Midlands CurrentSince Nov 27, 2016 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Nov 27, 2016 Accepting new patients

Locations

3555 Harden Street Ext
Ste 300
Columbia, SC 29203
Phone (803) 434-6411

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

9 Richland Medical Park Dr
Ste 505
Columbia, SC 29203
Phone (803) 434-2505

9 Richland Medical Park Dr
Ste 500
Columbia, SC 29203
Phone (803) 344-4555

Interoperability endpoints

  • Direct secure messaging: alewis381679@direct.ghs.myhfn.org

Organizations & group practices 2

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": "1224028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1225280720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 743904",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303743904",
            "telephone_number": "803-296-7320",
            "fax_number": "803-296-7330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 RICHLAND MEDICAL PARK DR",
            "address_2": "SUITE 500",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036859",
            "telephone_number": "803-434-4555",
            "fax_number": "803-434-4599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ALLISON",
        "middle_name": "GRACE",
        "name_prefix": "Mrs.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-15",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SC",
            "license": "3720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP1371",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.