NPIMap

Organization Active NPI

J C Lewis Primary Healthcare Center Inc

  • Federally Qualified Health Center (FQHC)
  • Savannah, GA
National Provider Identifier
1750734372
Registry record updated Nov 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
J C LEWIS PRIMARY HEALTHCARE CENTER INC
Practice address
3802 Waters Ave
Savannah, GA 31404-6210
Phone
(912) 352-3845
Fax
(912) 354-1980
NPI assigned
Jul 19, 2016
Last updated
Nov 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2023

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

Authorized official

Name
Tina Wright
Title
Credentialing
Phone
(912) 721-6704

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

3802 Waters Ave
Savannah, GA 31404-6210

Mailing address

5 Mall Anx
Savannah, GA 31406-4738
Phone (912) 721-6704

Other identifiers 1

IdentifierTypeStateIssuer
003104809AMedicaidGA

National Provider Directory

National Provider Directory
Tax ID family
JC Lewis Primary Healthcar6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3802 Waters Ave
Savannah, GA 31404
Phone (912) 352-3845

NPI Registry JSON

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1750734372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 MALL ANX",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064738",
            "telephone_number": "912-721-6704",
            "fax_number": "912-495-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046210",
            "telephone_number": "912-352-3845",
            "fax_number": "912-354-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J C LEWIS PRIMARY HEALTHCARE CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-19",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "912-721-6704"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003104809A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; 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.