Individual provider Active NPI

Raymond Ponald Lewis, D.C.

  • Chiropractor
  • Greenville, SC
National Provider Identifier
1265678254
Registry record updated Dec 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2205 Issued in SC
Practice address
2718 Wade Hampton Blvd Ste a
Greenville, SC 29615-1165
Phone
(864) 268-9040
NPI assigned
Dec 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 23, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2205 SC Primary

Addresses

Primary practice location

2718 Wade Hampton Blvd Ste a
Greenville, SC 29615-1165

Mailing address

2718 Wade Hampton Blvd Ste a
Greenville, SC 29615-1165
Phone (864) 268-9040

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

LicenseStateTypeSpecialty
2205SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthsource of Cherrydale Chiropractor Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1229990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1229990400000",
    "number": "1265678254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 WADE HAMPTON BLVD STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296151165",
            "telephone_number": "864-268-9040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2718 WADE HAMPTON BLVD STE A",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296151165",
            "telephone_number": "864-268-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "RAYMOND",
        "middle_name": "PONALD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-12-23",
        "last_updated": "2008-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2008; 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.