Gwendolyn Lewis

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

8767 Issued in MA

Practice address

5535 S Williamson Blvd
Ste 774
Port Orange, FL 32128-8311

Phone

(800) 330-7711

NPI assigned

Aug 12, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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": "1376265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1932532124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 WASHINGTON ST",
            "address_2": "APT1",
            "city": "WHITMAN",
            "state": "MA",
            "postal_code": "023821313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5535 S WILLIAMSON BLVD",
            "address_2": "STE 774",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321288311",
            "telephone_number": "800-330-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "GWENDOLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-12",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA12648",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "11228",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "8767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wirat Lertkitcharoenpon, PT,DPT
• Sue Levy, PSYD LCSW
• Lewis & Klancke Cardiology, P.a. (Daytona Heart Group)
• Kiana Lewis Francois, D.C.
• Cleophus Lewis
• Ladon Stacy Lewis, L.M.T.
• Sara Lenoir Lewis
• Yanelis Leyva, MSN, FNP-BC
• Libre Behavioral Healthcare LLC (Coastal Behavioral)
• Mary Kathleen Lichtenwalter, LMHC, CAP, CCS

• Speech-Language Pathologist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.