Individual provider Active NPI

Doretha Lewis

  • Pulmonary Rehabilitation Registered Respiratory Therapist
  • Waldorf, MD
National Provider Identifier
1306561923
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Rehabilitation Registered Respiratory TherapistTaxonomy code 2279P1005X
Practice address
22 Industrial Park Dr Ste a
Waldorf, MD 20602-2792
Phone
(301) 638-7543
NPI assigned
Oct 6, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Pulmonary Rehabilitation Registered Respiratory TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2279P1005X Primary

Addresses

Primary practice location

22 Industrial Park Dr Ste a
Waldorf, MD 20602-2792

Mailing address

9301 Annapolis Rd
Lanham, MD 20706-3115

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

Practice roles

OrganizationSpecialtyStatusNew patients
Vesta, Inc. CurrentSince Oct 9, 2022 Accepting new patients

Locations

9301 Annapolis Rd
Lanham, MD 20706
Phone (240) 296-5848

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": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665014400000",
    "number": "1306561923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9301 ANNAPOLIS RD",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 INDUSTRIAL PARK DR STE A",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022792",
            "telephone_number": "301-638-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DORETHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2279P1005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Respiratory Therapist, Registered, Pulmonary Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.