Individual provider Active NPI

Chantal Aneka Raheeda Lewis, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Dalton, GA
National Provider Identifier
1821439985
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
079901 Issued in GA
Practice address
475 Reed Rd Ste 104
Dalton, GA 30720-6310
Phone
(706) 278-1622
Fax
(706) 272-6445
NPI assigned
Jul 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 079901 GA Primary
Internal Medicine Physician 207R00000X 079901 GA
Internal Medicine Physician 207R00000X MT205027 PA

Addresses

Primary practice location

475 Reed Rd Ste 104
Dalton, GA 30720-6310

Mailing address

475 Reed Rd Ste 104
Dalton, GA 30720-6310
Phone (706) 278-1622

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181011002949 GA Practitioner - EndocrinologyPractitioner - Internal Medicine 9335439884 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
EndocrinologyAlso: Internal Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

3707 Largent Nwway
Marietta, GA 30064-5981
Phone (678) 581-5729

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

625 Church Nest
Marietta, GA 30060-1101
Phone (770) 422-2004

677 Church Nest
Marietta, GA 30060-1101

677 Church St NE
Suite 100P
Marietta, GA 30060-1101
Phone (470) 793-8585

Hospital & facility affiliations

  • Wellstar Kennestone Regional Medical Center Hospital, Marietta, GA, CCN 110035
  • Wellstar Cobb Medical Center Hospital, Austell, GA, CCN 110143
  • Wellstar Paulding Medical Center Hospital, Hiram, GA, CCN 110042
  • Wellstar Douglas Medical Center Hospital, Douglasville, GA, CCN 110184
  • Wellstar Windy Hill Hospital Long-term care hospital, Marietta, GA, CCN 112007

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
079901GAMDInternal Medicine Physician
MT205027PAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton Physician Group Inc CurrentSince Aug 6, 2018 Accepting new patients
Hamilton Medical Center, Inc. CurrentSince Aug 6, 2018 Accepting new patients
Wellstar Medical Group, LLC CurrentSince Jun 15, 2024 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Cardiovascular Medicine, LLC Past Accepting new patients

Locations

1200 Memorial Dr
Dalton, GA 30720
Phone (706) 272-6115

475 Reed Rd
Ste 104
Dalton, GA 30720
Phone (706) 278-1622

1109 Burleyson Rd
Ste 103
Dalton, GA 30720
Phone (706) 226-6445

1109 Burleyson Rd
Ste 104
Dalton, GA 30720
Phone (706) 278-5961

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

625 Church St NE
Marietta, GA 30060
Phone (770) 422-2004

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1374019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1821439985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 REED RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307206310",
            "telephone_number": "706-278-1622",
            "fax_number": "706-272-6445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 REED RD STE 104",
            "city": "DALTON",
            "state": "GA",
            "postal_code": "307206310",
            "telephone_number": "706-278-1622",
            "fax_number": "706-272-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "CHANTAL",
        "middle_name": "ANEKA RAHEEDA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-17",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "GA",
            "license": "079901",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "079901",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT205027",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dalton, GA

Sources for this page

Verify at the official NPI Registry.