Individual provider Active NPI

Preston L Lewis

  • Audiologist
  • Atlanta, GA
National Provider Identifier
1881210912
Registry record updated Jun 24, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD004237 Issued in GA
Practice address
960 Johnson Fy Rd NE Ste 200
Atlanta, GA 30342-1601
Phone
(404) 943-0900
NPI assigned
Jun 24, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193200000X MULTI-SPECIALTY GROUP 231H00000X AUD004237 GA Primary

Addresses

Primary practice location

960 Johnson Fy Rd NE Ste 200
Atlanta, GA 30342-1601

Mailing address

960 Johnson Fy Rd NE Ste 200
Atlanta, GA 30342-1601

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730001534 GA Practitioner - Qualified Audiologist 9638594294 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Group practices
Advanced Ear Nose and Throat Associates PCGroup PAC ID 2860443322, 6 clinicians

Practice addresses (Care Compare)

960 Johnson Ferry Rd
Suite 200
Atlanta, GA 30342-1601
Phone (404) 943-0090

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD004237GAMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Ear Nose and Throat Associates PC Multi-Specialty CurrentSince Jul 23, 2020 Accepting new patients

Locations

960 Johnson Fy Rd NE
Ste 200
Sandy Springs, GA 30342
Phone (404) 943-0090

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592956800000",
    "number": "1881210912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FY RD NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FY RD NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421601",
            "telephone_number": "404-943-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "PRESTON",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-24",
        "last_updated": "2020-06-24",
        "certification_date": "2020-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Audiologist",
            "state": "GA",
            "license": "AUD004237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.