Dedric Lewis, SCAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2251 Old Furnace Rd
Boiling Springs, SC 29316-5761

Phone

(864) 578-8465

NPI assigned

Aug 3, 2022

Last updated

Feb 21, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708473600000",
    "number": "1528795242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 PATEWOOD DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296153570",
            "telephone_number": "864-350-5037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2251 OLD FURNACE RD",
            "city": "BOILING SPRINGS",
            "state": "SC",
            "postal_code": "293165761",
            "telephone_number": "864-578-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "DEDRIC",
        "credential": "SCAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-03",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amilliah Wirula Kenya, DC
• Jennifer Lynn Kidane, PA
• Daniel Earl Kimbrell, PTA
• Jennifer Ann Kollock, NP
• Crystal Marie Lancaster, ATC
• Lis & Lauj LLC
• Chong Houa Lo, PHARMD
• Ryan Eddy Lutz, DC
• Jessica Marie Lyles
• Maryann Denise Lyles, MA, CCC-SLP

• Athletic Trainer in Boiling Springs, SC
• Providers in Boiling Springs, SC by specialty
• Athletic Trainer in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; 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.