Individual provider Active NPI

Samuel Watson Lewis, ATC, PT, DPT

  • Physical Therapist
  • Athens, GA
National Provider Identifier
1497216600
Registry record updated Mar 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016070 Issued in GA
Practice address
1061 Dowdy Rd
Athens, GA 30606-5700
Phone
(762) 728-4440
Fax
(762) 728-4441
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT003580 GA
Physical Therapist 225100000X PT016070 GA Primary

Addresses

Primary practice location

1061 Dowdy Rd
Athens, GA 30606-5700

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258

Other identifiers 1

IdentifierTypeStateIssuer
15680192OtherCAQH NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922001108 GA Practitioner - Physical Therapist in Private Practice 4688059926 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Philadelphia Col of Osteo Med, Sewanee, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Team Rehabilitation Services LLCGroup PAC ID 2264479518, 569 clinicians

Practice addresses (Care Compare)

1061 Dowdy Rd
Athens, GA 30606-5700
Phone (762) 728-4440

1689 Old Pendergrass Rd
Suite 300
Jefferson, GA 30549-2716
Phone (706) 387-0212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT016070GAMDPhysical Therapist
AT003580GAMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Apr 13, 2026 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 24, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 24, 2023 Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1061 Dowdy Rd
Ste 203
Athens, GA 30606
Phone (762) 728-4440

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

1689 Old Pendergrass Rd
Ste 300
Jefferson, GA 30549
Phone (706) 387-0212

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

Organizations & group practices 4

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": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773014400000",
    "number": "1497216600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 DOWDY RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306065700",
            "telephone_number": "762-728-4440",
            "fax_number": "762-728-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SAMUEL",
        "middle_name": "WATSON",
        "credential": "ATC, PT,  DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2026-03-09",
        "certification_date": "2026-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003580",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "15680192",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2026; 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.