Individual provider Active NPI

Michelle W Lewis, LCSW

  • Clinical Social Worker
  • Ahoskie, NC
National Provider Identifier
1922172238
Registry record updated Aug 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C004744 Issued in NC
Practice address
120 Health Center Dr
Ahoskie, NC 27910-8161
Phone
(252) 332-3548
Fax
(252) 332-1665
NPI assigned
Nov 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C004744 NC Primary

Addresses

Primary practice location

120 Health Center Dr
Ahoskie, NC 27910-8161

Mailing address

PO Box 669
Ahoskie, NC 27910-0669
Phone (252) 209-0237

Other identifiers 2

IdentifierTypeStateIssuer
138T1OtherNCBCBS PROVIDER NUMBER
6002942MedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050614000781 NC Practitioner - Clinical Social Worker 6507800232 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C004744NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Chowan Community Health Center Inc Current Accepting new patients
Roanoke Chowan Community Health Center Inc CurrentSince Oct 1, 2012 Accepting new patients
Roanoke Chowan Community Health Center Inc CurrentSince Oct 1, 2012 Accepting new patients

Locations

120 Health Center Dr
Ahoskie, NC 27910
Phone (252) 209-0237

305 Beechwood Blvd
Murfreesboro, NC 27855
Phone (252) 398-3323

Organizations & group practices 3

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504051200000",
    "number": "1922172238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 669",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279100669",
            "telephone_number": "252-209-0237",
            "fax_number": "252-209-0197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-332-3548",
            "fax_number": "252-332-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "MICHELLE",
        "middle_name": "W",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2017-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004744",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "138T1",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002942",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ahoskie, NC

Sources for this page

Verify at the official NPI Registry.