Roseanna Lewis, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

TEMP202439 Issued in GA

Practice address

3350 Ebenezer Rd SE
Conyers, GA 30094-3404

Phone

(000) 000-0000

NPI assigned

Aug 13, 2021

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1628812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1902571649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3974 ANNISTOWN RD APT 801",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300398472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 EBENEZER RD SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300943404",
            "telephone_number": "000-000-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "ROSEANNA",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-13",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "GA",
            "license": "TEMP202439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Na",
            "affiliation": "N",
            "endpointDescription": "Na",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Na",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Na",
            "address_1": "3350 Ebenezer Rd SE",
            "city": "Conyers",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300943404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Fulton D Lewis III, DMD
• John Terrence Lewis II, OTR/L
• Kendra Monet Lewis, LPC
• Kristin H Lewis, MD
• Mareba Lewis, LPC, CPCS, CRC
• Rosemary D. Lewis, RN
• Siohban Nicole Lewis, FNP-C
• Stefanie Daja Lewis
• Tyra Lewis
• Yanique Latoya Lewis, FNP-C

• Licensed Practical Nurse in Conyers, GA
• Providers in Conyers, GA by specialty
• Licensed Practical Nurse in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2021; 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.