Active NPI
Jerry Madison Lewter, RN
- Critical Care Medicine Registered Nurse
- Atlanta, GA
National Provider Identifier
1285699934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Medicine Registered Nurse
- License
- RN158379
- Practice address
- 3726 Ashford Dunwoody Rd NE
Apt N
Atlanta, GA 30319-1873 - Phone
- (678) 404-2343
- NPI assigned
- Apr 18, 2006
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | RN158379 | GA | |
| Registered Nurse | 163W00000X | RN158379 | GA | |
| Critical Care Medicine Registered Nurse | 163WC0200X | RN158379 | GA | Primary |
| Home Health Registered Nurse | 163WH0200X | RN158379 | GA | |
| Wound Care Registered Nurse | 163WW0000X | RN158379 | GA | |
| Hemodialysis Registered Nurse | 163WH0500X | RN158379 | GA | |
| General Practice Registered Nurse | 163WG0000X | RN158379 | GA |
Addresses
Primary practice location
3726 Ashford Dunwoody Rd NE
Apt N
Atlanta, GA 30319-1873
Mailing address
3726 Ashford Dunwoody Rd NE
Apt N
Atlanta, GA 30319-1873
Phone (678) 404-2343
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| RN158379 | Other | GA | RN LICENSE |
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN158379 | GA | MD | Critical Care Medicine Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145318400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301184000000",
"number": "1285699934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3726 ASHFORD DUNWOODY RD NE",
"address_2": "APT N",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303191873",
"telephone_number": "678-404-2343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3726 ASHFORD DUNWOODY RD NE",
"address_2": "APT N",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303191873",
"telephone_number": "678-404-2343"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWTER",
"first_name": "JERRY",
"middle_name": "MADISON",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-18",
"last_updated": "2011-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pediatrics",
"state": "GA",
"license": "RN158379",
"primary": false
},
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "RN158379",
"primary": false
},
{
"code": "163WC0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Critical Care Medicine",
"state": "GA",
"license": "RN158379",
"primary": true
},
{
"code": "163WH0200X",
"taxonomy_group": "",
"desc": "Registered Nurse, Home Health",
"state": "GA",
"license": "RN158379",
"primary": false
},
{
"code": "163WW0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Wound Care",
"state": "GA",
"license": "RN158379",
"primary": false
},
{
"code": "163WH0500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Hemodialysis",
"state": "GA",
"license": "RN158379",
"primary": false
},
{
"code": "163WG0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, General Practice",
"state": "GA",
"license": "RN158379",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN LICENSE",
"identifier": "RN158379",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.