Individual provider Active NPI

Stephen Daniel Lewis II, PTA

  • Physical Therapy Assistant
  • Norfolk, VA
National Provider Identifier
1336735570
Registry record updated Dec 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306602848 Issued in VA
Practice address
6201 E Virginia Beach Blvd Ste 110
Norfolk, VA 23502-2824
Phone
(757) 261-0820
Fax
(757) 461-3246
NPI assigned
Dec 11, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 2306602848 VA Primary

Addresses

Primary practice location

6201 E Virginia Beach Blvd Ste 110
Norfolk, VA 23502-2824

Mailing address

105 Inez Ave
Norfolk, VA 23502-5208
Phone (251) 472-7508

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
2306602848VAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Hospitals PastSince Dec 13, 2020 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": "1607644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607644800000",
    "number": "1336735570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 INEZ AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235025208",
            "telephone_number": "251-472-7508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 E VIRGINIA BEACH BLVD STE 110",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235022824",
            "telephone_number": "757-261-0820",
            "fax_number": "757-461-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "STEPHEN",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-11",
        "last_updated": "2020-12-11",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306602848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2020; 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.