Individual provider Active NPI

Christy Marie Lewis, LCSW

  • Clinical Social Worker
  • Knoxville, TN
National Provider Identifier
1750026464
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
627909 Issued in TN
Practice address
1100 Walden Legacy Way Apt 821
Knoxville, TN 37931-4786
Phone
(865) 414-2400
NPI assigned
Apr 28, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 627909 TN Primary

Addresses

Primary practice location

1100 Walden Legacy Way Apt 821
Knoxville, TN 37931-4786

Mailing address

1100 Walden Legacy Way Apt 821
Knoxville, TN 37931-4786
Phone (865) 414-2400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220906002628 TN Practitioner - Clinical Social Worker 7113301417 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians
Ultacare Medical PLLCGroup PAC ID 4789687484, 52 clinicians

Practice addresses (Care Compare)

482 Interstate Dr
Suite a
Manchester, TN 37355-3109
Phone (931) 728-4718

606 N Broad St
New Tazewell, TN 37825-6610
Phone (423) 259-5002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
627909TNMDClinical Social Worker
7136TNMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ultacare Medical PLLC Clinical CurrentSince May 31, 2022 Accepting new patients

Locations

1225 E Weisgarber Rd
Ste 190
Knoxville, TN 37909
Phone (423) 259-5002

5321 Beverly Park Cir
Knoxville, TN 37918
Phone (865) 414-2418

606 N Broad St
New Tazewell, TN 37825
Phone (423) 626-0466

5261 Carrollton Pike
Ste A
Woodlawn, VA 24381

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": "1651104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651104000000",
    "number": "1750026464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 WALDEN LEGACY WAY APT 821",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314786",
            "telephone_number": "865-414-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 WALDEN LEGACY WAY APT 821",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379314786",
            "telephone_number": "865-414-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CHRISTY",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "627909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.