Individual provider Active NPI

Alexis Coelho Lewis, PA-C

  • Physician Assistant
  • Charlotte, NC
National Provider Identifier
1801533823
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0010-14188 Issued in NC
Practice address
130 Providence Rd Ste 100
Charlotte, NC 28207-1247
Phone
(704) 333-9113
Fax
(704) 333-9757
NPI assigned
May 19, 2022
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9116176 FL
Physician Assistant 363A00000X 0010-14188 NC Primary

Addresses

Primary practice location

130 Providence Rd Ste 100
Charlotte, NC 28207-1247

Mailing address

130 Providence Rd Ste 100
Charlotte, NC 28207-1247
Phone (043) 339-1137

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20250429000505 NC Practitioner - Physician Assistant 4789100124 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Charlotte Skin and Laser PAGroup PAC ID 4880608603, 4 clinicians

Practice addresses (Care Compare)

9920 Kincey Ave
Suite 190
Huntersville, NC 28078-2428
Phone (704) 333-9113

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9116176FLMDPhysician Assistant

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1652918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1801533823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PROVIDENCE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071247",
            "telephone_number": "043-339-1137",
            "fax_number": "704-333-9757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PROVIDENCE RD STE 100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282071247",
            "telephone_number": "704-333-9113",
            "fax_number": "704-333-9757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ALEXIS",
        "middle_name": "COELHO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-19",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9116176",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-14188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.