Individual provider Active NPI

Marion Z Lewis, AGNP

  • Adult Health Nurse Practitioner
  • Gastonia, NC
National Provider Identifier
1821526526
Registry record updated May 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
165369 Issued in NC
Practice address
1875 Remount Rd
Gastonia, NC 28054-7413
Phone
(704) 874-0600
NPI assigned
May 25, 2017
Last updated
May 24, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 165369 NC Primary

Addresses

Primary practice location

1875 Remount Rd
Gastonia, NC 28054-7413

Mailing address

200 E 2ND Ave
Gastonia, NC 28052-4358
Phone (704) 874-0567

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
I20170722000072 NC Practitioner - Nurse Practitioner 9638449721 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
165369NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Centerwell Senior Primary Care (NC) PC CurrentSince Oct 14, 2024 Accepting new patients
Gaston Family Health Services, Inc. CurrentSince May 20, 2019 Accepting new patients
Gaston Family Health Services, Inc CurrentSince May 20, 2019 Accepting new patients
Centerwell Senior Primary Care (NC), P.C. CurrentSince Oct 14, 2024 Accepting new patients
Centerwell Senior Primary Care (NC) PC Past Accepting new patients

Locations

6101 Waterford District Dr
Ste 200
Miami, FL 33126
Phone (407) 533-6836

1875 Remount Rd
Gastonia, NC 28054
Phone (704) 874-0600

200 E 2nd Ave
Gastonia, NC 28052
Phone (704) 874-1904

2910 E Franklin Blvd
Ste 1
Gastonia, NC 28056
Phone (704) 648-0460

991 W Hudson Blvd
Gastonia, NC 28052
Phone (704) 853-5000

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, 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": "1495670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558656000000",
    "number": "1821526526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 E 2ND AVE",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280524358",
            "telephone_number": "704-874-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1875 REMOUNT RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280547413",
            "telephone_number": "704-874-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MARION",
        "middle_name": "Z",
        "credential": "AGNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-25",
        "last_updated": "2019-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "165369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gastonia, NC

Sources for this page

Verify at the official NPI Registry.