Active NPI
Ross Lewis
- Physical Therapy Assistant
- Valdosta, GA
National Provider Identifier
1225763576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA004367
- Practice address
- 2501 N Patterson St
Valdosta, GA 31602-1785 - Phone
- (229) 333-1000
- NPI assigned
- Jul 20, 2022
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA29793 | FL | |
| Physical Therapy Assistant | 225200000X | PTA004367 | GA | Primary |
Addresses
Primary practice location
2501 N Patterson St
Valdosta, GA 31602-1785
Mailing address
26473 61St Rd
Branford, FL 32008-2427
Phone (386) 854-0792
Other practice location 1
560 SW McFarlane Ave
Lake City, FL 32025-5614
Phone (386) 758-4777
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | ross.lewis@sgmc.org | Direct | South Georgia Medical Center |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA29793 | FL | MD | Physical Therapy Assistant |
| PTA004367 | GA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1658275200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658275200000",
"number": "1225763576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26473 61ST RD",
"city": "BRANFORD",
"state": "FL",
"postal_code": "320082427",
"telephone_number": "386-854-0792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2501 N PATTERSON ST",
"city": "VALDOSTA",
"state": "GA",
"postal_code": "316021785",
"telephone_number": "229-333-1000"
}
],
"practiceLocations": [
{
"address_1": "560 SW McFarlane Ave",
"address_purpose": "LOCATION",
"city": "Lake City",
"state": "FL",
"postal_code": "320255614",
"country_code": "US",
"telephone_number": "386-758-4777",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEWIS",
"first_name": "ROSS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-07-20",
"last_updated": "2022-07-20",
"certification_date": "2022-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "FL",
"license": "PTA29793",
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA004367",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "ross.lewis@sgmc.org",
"affiliation": "Y",
"affiliationName": "South Georgia Medical Center",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2501 N Patterson St",
"city": "Valdosta",
"state": "GA",
"country_code": "US",
"postal_code": "316021785",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Valdosta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.