Individual provider Active NPI

Jerome Lewis II, D.C

  • Chiropractor
  • Augusta, GA
National Provider Identifier
1669929568
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CHIR010307 Issued in GA
Practice address
816 Broad St
Augusta, GA 30901-1215
Phone
(706) 589-0213
NPI assigned
Sep 8, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4675 NC
Chiropractor 111N00000X CHIR010307 GA Primary

Addresses

Primary practice location

816 Broad St
Augusta, GA 30901-1215

Mailing address

816 Broad St
Augusta, GA 30901-1215
Phone (706) 399-9083

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210204002742 GA Practitioner - Chiropractic 2567740608 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Tuff Spine LLC Chiropractor CurrentSince Nov 10, 2020 Accepting new patients
Wirth Chiropractic PA Chiropractor PastSince May 16, 2022 Accepting new patients

Locations

816 Broad St
Augusta, GA 30901
Phone (706) 589-0213

138 8th St
Augusta, GA 30901
Phone (706) 589-0213

Organizations & group practices 2

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": "1473292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724716800000",
    "number": "1669929568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "816 BROAD ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309011215",
            "telephone_number": "706-399-9083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "816 BROAD ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309011215",
            "telephone_number": "706-589-0213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "JEROME",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-09-08",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "4675",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "CHIR010307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.