Individual provider Active NPI

Thomas G. Lewis Jr.

  • Emergency Medicine Physician
  • Florence, SC
National Provider Identifier
1568469674
Registry record updated Oct 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0270101 Issued in SC
Practice address
555 E Cheves St
Florence, SC 29506-2617
Phone
(777) 843-2027
Fax
(843) 777-5035
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 0270101 SC Primary

Addresses

Primary practice location

555 E Cheves St
Florence, SC 29506-2617

Mailing address

PO Box 100567
Florence, SC 29501-0567
Phone (843) 777-5813

Other identifiers 1

IdentifierTypeStateIssuer
270101MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040908000959 SC Practitioner - Emergency Medicine 4385619337 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0270101SCMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Health Cheraw Emergency Medicine CurrentSince Aug 23, 2023 Accepting new patients
McLeod Health Cheraw CurrentSince Aug 23, 2023 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jul 1, 2004 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Jul 1, 2004 Accepting new patients
Prisma Health-Midlands Past Accepting new patients
Serio South Carolina, LLC Emergency Medicine Past Accepting new patients

Locations

711 Chesterfield Hwy
Cheraw, SC 29520
Phone (843) 320-3304

301 E Jackson St
Dillon, SC 29536
Phone (843) 774-1166

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

Organizations & group practices 6

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1286323200000",
    "number": "1568469674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100567",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295010567",
            "telephone_number": "843-777-5813",
            "fax_number": "843-777-5035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 E CHEVES ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295062617",
            "telephone_number": "777-843-2027",
            "fax_number": "843-777-5035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "THOMAS",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2010-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "SC",
            "license": "0270101",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "270101",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Florence, SC

Sources for this page

Verify at the official NPI Registry.