Individual provider Active NPI

Lonnell Fericl Lewis

  • Clinical Social Worker
  • Palmyra, VA
National Provider Identifier
1427585348
Registry record updated Mar 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0904009706 Issued in VA
Practice address
265 Turkeysag TRL Ste 114B
Palmyra, VA 22963-2654
Phone
(434) 806-3869
NPI assigned
May 23, 2017
Last updated
Mar 20, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0904009706 VA Primary

Addresses

Primary practice location

265 Turkeysag TRL Ste 114B
Palmyra, VA 22963-2654

Mailing address

PO Box 471
Palmyra, VA 22963-0471

Other practice location 1

3623 Saunders Ave
Richmond, VA 23227-4354
Phone (804) 521-4050

Other identifiers 1

IdentifierTypeStateIssuer
0904009706OtherVABOARD OF SOCIAL WORK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191015002423 VA Practitioner - Clinical Social Worker 5092046508 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Circle of Wellness LLCGroup PAC ID 7416287842, 5 clinicians

Practice addresses (Care Compare)

9321 Midlothian Tpke
Suite C
North Chesterfield, VA 23235-4941
Phone (804) 252-4525

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0904009706VAMDClinical Social Worker

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1495497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1427585348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 471",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229630471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 TURKEYSAG TRL STE 114B",
            "city": "PALMYRA",
            "state": "VA",
            "postal_code": "229632654",
            "telephone_number": "434-806-3869"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3623 Saunders Ave",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "VA",
            "postal_code": "232274354",
            "country_code": "US",
            "telephone_number": "804-521-4050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "LONNELL",
        "middle_name": "FERICL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-05-23",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VA",
            "license": "0904009706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF SOCIAL WORK",
            "identifier": "0904009706",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palmyra, VA

Sources for this page

Verify at the official NPI Registry.