Individual provider Active NPI

Arlene Annetta Lewis, M.D.

  • Adult Medicine Physician
  • Conyers, GA
National Provider Identifier
1245241975
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
License
043236 Issued in GA
Practice address
1383 Manchester Dr NE Ste B
Conyers, GA 30012
Phone
(770) 981-2443
Fax
(770) 981-2478
NPI assigned
Aug 10, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 25, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine Physician 207QA0505X 043236 GA Primary

Addresses

Primary practice location

1383 Manchester Dr NE Ste B
Conyers, GA 30012

Mailing address

1383 Manchester Dr NE Ste B
Conyers, GA 30012-3882
Phone (770) 981-2443

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190214002751 GA Practitioner - Family Practice 7911270764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
State University of New York Downstate Medical Center, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1383 Manchester Dr NE
Conyers, GA 30012-3882
Phone (770) 981-2443

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
043236GAMDAdult Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care of Hillandale, P.C. CurrentSince Nov 11, 2018 Accepting new patients

Locations

1383 Manchester Dr NE
#B
Conyers, GA 30012
Phone (770) 438-4388

1383 Manchester Dr NE
Conyers, GA 30012
Phone (770) 981-2443

Organizations & group practices 1

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1245241975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1383 MANCHESTER DR NE STE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123882",
            "telephone_number": "770-981-2443",
            "fax_number": "770-981-2478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1383 MANCHESTER DR NE STE B",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "770-981-2443",
            "fax_number": "770-981-2478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ARLENE",
        "middle_name": "ANNETTA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-10",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "GA",
            "license": "043236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.