Active NPI
Ryan Lewis, M.D.
- Emergency Medicine Physician
- Augusta, GA
National Provider Identifier
1811197163
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 067357
- Practice address
- 1120 15TH St
Augusta, GA 30912-0004 - Phone
- (706) 721-0211
- NPI assigned
- Jul 24, 2007
- Last updated
- Sep 30, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 719-L | MS | |
| Emergency Medicine Physician | 207P00000X | 067357 | GA | Primary |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-0004
Mailing address
1499 Walton Way
Ste 1400
Augusta, GA 30901-2602
Phone (706) 828-6410
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 719-L | MS | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Star ER, LLC | Past | Accepting new patients |
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": "1185235200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380499200000",
"number": "1811197163",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1499 WALTON WAY",
"address_2": "STE 1400",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309012602",
"telephone_number": "706-828-6410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-0211"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEWIS",
"first_name": "RYAN",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-07-24",
"last_updated": "2013-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MS",
"license": "719-L",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "GA",
"license": "067357",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.