Individual provider Active NPI

Colette E Lee-Lewis, MD

  • Nephrology Physician
  • Brunswick, GA
National Provider Identifier
1861695892
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
055783 Issued in GA
Practice address
3025 Shrine Rd
Ste 270
Brunswick, GA 31520
Phone
(912) 262-2723
Fax
(877) 244-5666
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 055783 GA Primary

Addresses

Primary practice location

3025 Shrine Rd
Ste 270
Brunswick, GA 31520

Mailing address

3025 Shrine Rd
Ste 270
Brunswick, GA 31520
Phone (912) 262-2723

Other identifiers 4

IdentifierTypeStateIssuer
630423104AMedicaidGA
01035668OtherGAAMERIGROUP
P00215034OtherGARILROAD MEDICARE
52043977OtherGABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20050415000124 GA Practitioner - Internal MedicinePractitioner - Nephrology 8921045451 Reassigns benefits to 1 organization
I20140905001392 AL Practitioner - Internal Medicine 8921045451 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Nephrology
Education
Hahnemann University College of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ahmed Elsharkawi MD LLCGroup PAC ID 4385781467, 7 clinicians

Practice addresses (Care Compare)

3025 Shrine Rd
Suite 270
Brunswick, GA 31520-4785
Phone (912) 262-2723

Hospital & facility affiliations

  • DaVita Brunswick Dialysis Dialysis facility, Brunswick, GA, CCN 112514
  • DaVita Jesup Dialysis Dialysis facility, Jesup, GA, CCN 112532
  • Centerwell Home Health Home health agency, Brunswick, GA, CCN 117144
  • Community Home Care Home health agency, Jesup, GA, CCN 117012
  • Southeast Georgia Health System- Brunswick Campus Hospital, Brunswick, GA, CCN 110025
  • Wayne Memorial Hospital Hospital, Jesup, GA, CCN 110124
  • Southeast Georgia Health System -- Camden Campus Hospital, Saint Marys, GA, CCN 110146
  • Memorial Satilla Health Hospital, Waycross, GA, CCN 110003
  • Jeff Davis Hospital Hospital, Hazlehurst, GA, CCN 111333

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ahmed Elsharkawi MD LLC Nephrology CurrentSince Dec 20, 2018 Accepting new patients
Houston County Healthcare Authority Current Accepting new patients
Houston County Healthcare Authority CurrentSince Jun 21, 2014 Accepting new patients
Brunswick Urgent Care, LLC CurrentSince Apr 20, 2019 Accepting new patients
Houston County Healthcare Authority CurrentSince Jun 21, 2014 Accepting new patients
A T Ordinario Jr MD LLC Nephrology Past Accepting new patients
Macmed LLC Past Accepting new patients
Soliant Health Past Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

105 E Tollison St
Ste B
Baxley, GA 31513
Phone (912) 367-0102

2415 Parkwood Dr
Brunswick, GA 31520
Phone (912) 466-4079

208 Scranton Connector
Ste 117
Brunswick, GA 31525
Phone (912) 264-5961

3025 Shrine Rd
Ste 270
Brunswick, GA 31520
Phone (912) 262-2723

475 Gateway Center Blvd
Brunswick, GA 31525
Phone (912) 265-0533

823 S 1st St
Jesup, GA 31545
Phone 9122831359185

234 Kings Bay Rd
Kingsland, GA 31548

2040 Dan Proctor Dr
Ste 200
Saint Marys, GA 31558
Phone (912) 576-6376

Interoperability endpoints

  • Direct secure messaging: colette.lee-lewis@685165133824004.direct.elationemr.com

Organizations & group practices 8

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 9

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1861695892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3025 SHRINE RD",
            "address_2": "STE 270",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-262-2723",
            "fax_number": "877-244-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 SHRINE RD",
            "address_2": "STE 270",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31520",
            "telephone_number": "912-262-2723",
            "fax_number": "877-244-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE-LEWIS",
        "first_name": "COLETTE",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "055783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630423104A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01035668",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RILROAD MEDICARE",
            "identifier": "P00215034",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "52043977",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

Verify at the official NPI Registry.