Individual provider Active NPI

Sandra Ellen Lewis, CRNA

  • Certified Registered Nurse Anesthetist
  • Richmond, VA
National Provider Identifier
1407158918
Registry record updated Dec 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
6650 Issued in NC
Practice address
10800 Midlothian Tpke
Suite 265
Richmond, VA 23235-4724
Phone
(804) 594-2622
Fax
(804) 594-0915
NPI assigned
Dec 3, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN1007029 DC
Certified Registered Nurse Anesthetist 367500000X 6650 NC Primary
Certified Registered Nurse Anesthetist 367500000X 0024169208 VA

Addresses

Primary practice location

10800 Midlothian Tpke
Suite 265
Richmond, VA 23235-4724

Mailing address

240 New River Dr
Jacksonville, NC 28540-5927
Phone (804) 594-2622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110518000493 VA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870779390 Reassigns benefits to 2 organizations
I20211220001988 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 3870779390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Onslow Memorial Hospital IncGroup PAC ID 1456252899, 65 clinicians

Practice addresses (Care Compare)

317 Western Boulevard
Jacksonville, NC 28546-6338
Phone (910) 577-2345

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN1007029DCMDRegistered Nurse
6650NCMDSpeech-Language Pathologist
0024169208VAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Onslow Memorial Hospital, Inc. CurrentSince Oct 25, 2021 Accepting new patients
Commonwealth Anesthesia Associates, P.C. CurrentSince Feb 28, 2011 Accepting new patients
Onslow Memorial Hospital Inc CurrentSince Oct 25, 2021 Accepting new patients
American Anesthesiology of Virginia, PC CurrentSince Jun 1, 2021 Accepting new patients
American Anesthesiology of Virginia PC Current Accepting new patients

Locations

241 New River Dr
Jacksonville, NC 28540
Phone (910) 430-4152

317 Western Blvd
Jacksonville, NC 28546
Phone (910) 577-2240

19455 Deerfield Ave
Ste 204
Leesburg, VA 20176
Phone (703) 724-9950

10800 Midlothian Tpke
Ste 265
North Chesterfield, VA 23235
Phone (804) 594-1383

7858 Shrader Rd
Richmond, VA 23294
Phone (804) 287-2780

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1291334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1407158918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 NEW RIVER DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285405927",
            "telephone_number": "804-594-2622",
            "fax_number": "804-594-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10800 MIDLOTHIAN TPKE",
            "address_2": "SUITE 265",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232354724",
            "telephone_number": "804-594-2622",
            "fax_number": "804-594-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SANDRA",
        "middle_name": "ELLEN",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-03",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DC",
            "license": "RN1007029",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "6650",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "VA",
            "license": "0024169208",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.