Individual provider Active NPI

Kimberly Lewis, DC

  • Chiropractor
  • Aiken, SC
National Provider Identifier
1366446932
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2563 Issued in SC
Practice address
1028 Richland Ave E
Aiken, SC 29801-4760
Phone
(803) 648-0172
Fax
(803) 648-5062
NPI assigned
Jun 10, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2563 SC Primary

Addresses

Primary practice location

1028 Richland Ave E
Aiken, SC 29801-4760

Mailing address

1028 Richland Ave E
Aiken, SC 29801-4760
Phone (803) 648-0172

Other identifiers 1

IdentifierTypeStateIssuer
CH2563MedicaidSC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
2563SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Chiropractic and Wellness Center LLC Chiropractor PastSince Aug 16, 2019 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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366446932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1028 RICHLAND AVE E",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298014760",
            "telephone_number": "803-648-0172",
            "fax_number": "803-648-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 RICHLAND AVE E",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "298014760",
            "telephone_number": "803-648-0172",
            "fax_number": "803-648-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KIMBERLY",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "2563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH2563",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.