Individual provider Active NPI

Donna Lewis

  • Family Nurse Practitioner
  • Mullins, SC
National Provider Identifier
1245604586
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19865 Issued in SC
Practice address
5401 Fairview Rd
Mullins, SC 29574-6814
Phone
(843) 496-8443
NPI assigned
Nov 24, 2015
Last updated
Nov 24, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19865 SC Primary

Addresses

Primary practice location

5401 Fairview Rd
Mullins, SC 29574-6814

Mailing address

5401 Fairview Rd
Mullins, SC 29574-6814
Phone (843) 496-8443

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
I20180627000829 SC Practitioner - Nurse Practitioner 7416203815 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Falk Family Total Health LLCGroup PAC ID 6204257181, 3 clinicians

Practice addresses (Care Compare)

1501 9TH Ave
Conway, SC 29526-4107
Phone (843) 248-0104

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Falk Family Total Health, LLC CurrentSince Mar 1, 2020 Accepting new patients
Falk Family Chiropractic Center P.C PastSince Jul 1, 2004 Accepting new patients
McLeod Occupational Health, LLC Past Accepting new patients

Locations

1501 9th Ave
Conway, SC 29526
Phone (843) 248-0104

Interoperability endpoints

  • Direct secure messaging: dlewis26503@directmcleodehealth.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1245604586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 FAIRVIEW RD",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746814",
            "telephone_number": "843-496-8443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 FAIRVIEW RD",
            "city": "MULLINS",
            "state": "SC",
            "postal_code": "295746814",
            "telephone_number": "843-496-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DONNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullins, SC

Sources for this page

Verify at the official NPI Registry.