NPIMap

Individual provider Active NPI

Kristin H Lewis, MD

  • Diagnostic Radiology Physician
  • Conyers, GA
National Provider Identifier
1881676245
Registry record updated Apr 23, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
37599 Issued in GA
Practice address
1412 Milstead Ave NE
Conyers, GA 30012-3877
Phone
(770) 607-7339
NPI assigned
Nov 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 37599 GA Primary

Addresses

Primary practice location

1412 Milstead Ave NE
Conyers, GA 30012-3877

Mailing address

PO Box 200096
Cartersville, GA 30120-9002
Phone (770) 607-7339

Other identifiers 1

IdentifierTypeStateIssuer
000892691AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050928000722 GA Practitioner - Diagnostic Radiology 2860427838 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wake Forest University School of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Radiology Services P CGroup PAC ID 3577454024, 70 clinicians

Practice addresses (Care Compare)

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120-2129
Phone (770) 382-1530

Hospital & facility affiliations

  • Piedmont Henry Hospital Hospital, Stockbridge, GA, CCN 110191
  • Piedmont Newton Hospital Hospital, Covington, GA, CCN 110018
  • Piedmont Rockdale Hospital Hospital, Conyers, GA, CCN 110091
  • Piedmont Cartersville Medical Center Hospital, Cartersville, GA, CCN 110030
  • Piedmont Mountainside Hospital Inc Hospital, Jasper, GA, CCN 110225

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
88.58 of 100Reported as group
Quality
85.31
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
37599GAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Imaging Center CurrentSince Jun 1, 2022 Accepting new patients
Summit Radiology Services P C Diagnostic Radiology CurrentSince Jun 29, 2018 Accepting new patients
Summit Imaging Services LLC Diagnostic Radiology CurrentSince Mar 20, 2024 Accepting new patients
Rockdale Diagnostics, LLC Past Accepting new patients
Tanner Medical Group Inc PastSince Jun 1, 2022 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Genesis Women'S Diagnostic Center Diagnostic Radiology Past Accepting new patients

Locations

706 Dixie St
Ste 100
Carrollton, GA 30117
Phone (770) 812-8614

960 Joe Frank Harris Pkwy SE
Cartersville, GA 30120
Phone (404) 554-2196

145 E Peacock St
Cochran, GA 31014
Phone (229) 200-4950

1412 Milstead Ave NE
Conyers, GA 30012
Phone (770) 918-3000

222 Perry Hwy
Hawkinsville, GA 31036
Phone (229) 200-4950

1266 Highway 515 S
Jasper, GA 30143
Phone (706) 301-5350

Organizations & group practices 9

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1881676245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200096",
            "city": "CARTERSVILLE",
            "state": "GA",
            "postal_code": "301209002",
            "telephone_number": "770-607-7339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 MILSTEAD AVE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123877",
            "telephone_number": "770-607-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "KRISTIN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-18",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "GA",
            "license": "37599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000892691A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

Verify at the official NPI Registry.