Sandra J Lewis, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18980 Issued in WV

Practice address

4004 Maccorkle Ave SE
Suite 1a
Charleston, WV 25304-1672

Phone

(304) 926-0172

NPI assigned

Sep 27, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sandra J Lewis M.D. P.L.L.C.

  • Primary Care Clinic/Center
  • Charleston, WV
  • NPI 1487849485
  NPD (past) Authorized official

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841381035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WOODSCAPE WAY",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609322",
            "telephone_number": "304-760-0447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4004 MACCORKLE AVE SE",
            "address_2": "SUITE 1A",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253041672",
            "telephone_number": "304-926-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SANDRA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "18980",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054964000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Michael Lewis, SLP
• Maryellen Casey Lewis
• Monica Lewis, CLINICAL COUNSELOR
• Nicole Lewis
• Robin A Lewis, NP
• Stephen A Lewis, MD
• Temeka Dawn Lewis, PHARMD
• Tiffany Lewis
• Wendy Lenora Lewis, LPC
• Dranda Lewus

• Family Medicine Physician in Charleston, WV
• Providers in Charleston, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.