NPIMap

Organization Active NPI

Sandra J Lewis M.D. P.L.L.C.

  • Primary Care Clinic/Center
  • Charleston, WV
National Provider Identifier
1487849485
Registry record updated Sep 12, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
18980 Issued in WV
Legal business name
SANDRA J LEWIS M.D. P.L.L.C.
Practice address
4004 Maccorkle Ave SE
Charleston, WV 25304-1672
Phone
(304) 926-0172
NPI assigned
Sep 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2007

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

Authorized official

Name
Dr. Sandra J Lewis, MDNPI 1841381035
Title
Owner/Physician
Phone
(304) 926-0172

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 18980 WV Primary

Addresses

Primary practice location

4004 Maccorkle Ave SE
Charleston, WV 25304-1672

Mailing address

4004 Maccorkle Ave SE
Charleston, WV 25304-1672
Phone (304) 926-0172

National Provider Directory

National Provider Directory

Locations

4004 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 926-0172

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189555200000",
    "number": "1487849485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041672",
            "telephone_number": "304-926-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 MACCORKLE AVE SE",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041672",
            "telephone_number": "304-926-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDRA J LEWIS M.D. P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-12",
        "last_updated": "2007-09-12",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "304-926-0172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "WV",
            "license": "18980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.