Individual provider Active NPI

Jenee Lewis-Walker, PSY.D., LCP

  • Clinical Psychologist
  • Richmond, VA
National Provider Identifier
1457680217
Registry record updated Dec 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
0810004189 Issued in VA
Practice address
107 S 5TH St
Richmond, VA 23219-3825
Phone
(804) 819-4000
NPI assigned
Dec 8, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 0810004189 VA Primary

Addresses

Primary practice location

107 S 5TH St
Richmond, VA 23219-3825

Mailing address

107 S 5TH St
Richmond, VA 23219-3825
Phone (804) 819-4000

Other identifiers 1

IdentifierTypeStateIssuer
4945255MedicaidVA

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
I20110603000152 VA Practitioner - Clinical Psychologist 4880871672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spectrum Transformation Group, LLCGroup PAC ID 8527253830, 10 clinicians

Practice addresses (Care Compare)

221 Stonebridge Plaza Ave
North Chesterfield, VA 23225-6972
Phone 8043786141304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Transformation Group, LLC CurrentSince Oct 1, 2023 Accepting new patients

Locations

221 Stonebridge Plaza Ave
North Chesterfield, VA 23225
Phone (804) 378-6141

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": "1260230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260230400000",
    "number": "1457680217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S 5TH ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232193825",
            "telephone_number": "804-819-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS-WALKER",
        "first_name": "JENEE",
        "credential": "PSY.D., LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-08",
        "last_updated": "2009-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004189",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4945255",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.