Lillianne Marie Lewis Debnam, MD, MPH
Individual provider Active NPI Pediatrics Physician · Georgetown, SC
NPI 1972869774 · NPPES record last updated Jul 15, 2024
Key facts
- NPI
- 1972869774
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 074570 (GA)
- Practice address
- 57 Jessamine Ave
Georgetown, SC 29440-5837 - Phone
- (843) 546-8686
- Fax
- (843) 546-1353
- NPI assigned
- Apr 5, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in GA, SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181212003725 | GA | Practitioner - Pediatric Medicine | 2860737285 | Reassigns benefits to 1 organization |
| I20250130002064 | SC | Practitioner - Pediatric Medicine | 2860737285 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 074570 | GA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. James Health and Wellness Inc. | Current |
Accepting new patients | |
| St James Health and Wellness Inc | Current | Accepting new patients | |
| Morehouse Healthcare, Inc. | Pediatrics | Current |
Accepting new patients |
| St James Health and Wellness Inc | Current |
Accepting new patients |
Locations
720 Westview Dr SW
Atlanta, GA 30310
Phone (404) 756-1383
1800 Howell Mill Rd NW
Ste 550
Atlanta, GA 30318
Phone (404) 756-1290
35 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 785-9500
720 Westview Dr SW
Bldg 100A
Atlanta, GA 30310
1595 Cleveland Ave
East Point, GA 30344
Phone (404) 305-8086
57 Jessamine Ave
Georgetown, SC 29440
Phone (843) 546-8686
1189 Tibwin Rd
Mc Clellanville, SC 29458
Phone (843) 887-3929
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 86761 | SC | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | 074570 | GA | Yes |
Addresses
Primary practice location
57 Jessamine Ave
Georgetown, SC 29440-5837
Mailing address
57 Jessamine Ave
Georgetown, SC 29440-5837
Phone (843) 546-8686
Other practice location 1
720 Westview Dr SW
Atlanta, GA 30310-1458
Phone (404) 752-1857
Other names
- Dr. Lillianne Marie Lewis
Other providers in Georgetown, SC
- Janese Daniels
- Kelli S Daughtry
- Gerald Allen Davidson
- Carol Davison
- Robert Edwin Deane
- Richard E. Dechamplain
- Pamela Jean Dechellis
- Diana Dennison
- John Fredric Denton
- George T Deschamps Jr.
All providers in Georgetown, SC · Pediatrics Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 15, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.