Individual provider Active NPI

Nikiya L Lewis

  • Women's Health Nurse Practitioner
  • Statesboro, GA
National Provider Identifier
1700161072
Registry record updated Dec 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
RN184063NP Issued in GA
Practice address
1310 Brampton Ave
Statesboro, GA 30458-0851
Phone
(912) 871-6206
Fax
(912) 681-8558
NPI assigned
Oct 18, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X RN184063NP GA Primary

Addresses

Primary practice location

1310 Brampton Ave
Statesboro, GA 30458-0851

Mailing address

1310 Brampton Ave
Statesboro, GA 30458-0851
Phone (912) 871-6206

Other practice location 1

1501 Brampton Ave
Statesboro, GA 30458-0856
Phone (912) 871-6206

Other identifiers 3

IdentifierTypeStateIssuer
003114992BMedicaidGA
1700161072OtherNPI
RN184063NPOtherGAGA LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160919000850 GA Practitioner - Nurse Practitioner 3375830441 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ogeechee OBGYN, P.C.Group PAC ID 0244211308, 6 clinicians

Practice addresses (Care Compare)

1310 Brampton Ave
Statesboro, GA 30458-0851
Phone (912) 871-6206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN184063NPGAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Emanuel County Hospital Authority Current Accepting new patients
Ogeechee OB-GYN, LLC CurrentSince Sep 2, 2025 Accepting new patients

Locations

1310 Brampton Ave
Statesboro, GA 30458
Phone (912) 486-1873

1501 Brampton Ave
Statesboro, GA 30458
Phone (912) 871-6197

117 Kite Rd
Swainsboro, GA 30401
Phone (248) 972-8725

125B Victory Dr
Swainsboro, GA 30401
Phone (478) 237-5850

209C Mims Rd
Sylvania, GA 30467
Phone (912) 564-5977

Interoperability endpoints

  • Direct secure messaging: nikiya.lewis.1@24280.direct.athenahealth.com

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": "1318896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767139200000",
    "number": "1700161072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580851",
            "telephone_number": "912-871-6206",
            "fax_number": "912-681-8558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 BRAMPTON AVE",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580851",
            "telephone_number": "912-871-6206",
            "fax_number": "912-681-8558"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Brampton Ave",
            "address_purpose": "LOCATION",
            "city": "Statesboro",
            "state": "GA",
            "postal_code": "304580856",
            "country_code": "US",
            "telephone_number": "912-871-6206",
            "fax_number": "912-681-8558",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "NIKIYA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-18",
        "last_updated": "2025-12-31",
        "certification_date": "2025-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "GA",
            "license": "RN184063NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003114992B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1700161072",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA LICENSE",
            "identifier": "RN184063NP",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.