Ericka Nicole Lewis

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

License

236831 Issued in FL

Practice address

812 16TH Ave SE
Ruskin, FL 33570-6013

Phone

(813) 476-8343

NPI assigned

Sep 7, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Chase Quality Care

  • Developmental Disabilities Clinic/Center
  • Ruskin, FL
  • NPI 1356217327
  NPD Authorized official

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1740901776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 16TH AVE SE",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335706013",
            "telephone_number": "813-476-8343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 16TH AVE SE",
            "city": "RUSKIN",
            "state": "FL",
            "postal_code": "335706013",
            "telephone_number": "813-476-8343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ERICKA",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "FL",
            "license": "236831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "833874018",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "n/a",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "n/a",
            "address_1": "812 16th Ave SE",
            "city": "Ruskin",
            "state": "FL",
            "country_code": "US",
            "postal_code": "335706013",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Lavoia Adult Family Care Home LLC
• James X Lawrence, OD
• Shannon Leigh, LCSW
• Angeline Leon, DPT
• Ashaki Christina Lewis
• Tara Litsey, COTA/L
• Living Well Healthcare Corporation
• Harold James Lochner III, MD
• Sirena Loftley
• Stephanie Lopez

• Developmental Disabilities Clinic/Center in Ruskin, FL
• Providers in Ruskin, FL by specialty
• Developmental Disabilities Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.