Montrelle Latwan Lewis, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3566 Issued in SC

Practice address

2199 N Fraser St
Georgetown, SC 29440-6409

Phone

(843) 527-6835

NPI assigned

Oct 3, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1601683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601683200000",
    "number": "1336746338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7704 BROWNS FERRY RD",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294405644",
            "telephone_number": "843-325-5660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2199 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294406409",
            "telephone_number": "843-527-6835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MONTRELLE",
        "middle_name": "LATWAN",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-03",
        "last_updated": "2020-10-03",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "SC",
            "license": "3566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lend a Hand
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• Dana Lev-Ran, MD
• Jennifer Lynn Lewis, PT, DPT, ATP
• Monica Denise Lewis, FNP
• Lifeline Respiratory Services LLC
• Lindsay H Moore, DMD PA
• Michele Lively, APRN
• Pam Amanda Locke, CRNA
• Margaret Elaine Loftin, M.A., LPC

• Physical Therapy Assistant in Georgetown, SC
• Providers in Georgetown, SC by specialty
• Physical Therapy Assistant in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 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.