Shannin Dion Lewis, D.O

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

25MB09229100 Issued in NJ

Practice address

204 Grove Ave Ste C
West Deptford, NJ 08086-2557

Phone

(856) 537-6427

NPI assigned

Dec 9, 2008

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

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595289600000",
    "number": "1992940670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 GROVE AVE STE C",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862557",
            "telephone_number": "856-537-6427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 GROVE AVE STE C",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862557",
            "telephone_number": "856-537-6427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS",
        "first_name": "SHANNIN",
        "middle_name": "DION",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "PA",
            "license": "OS016366",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "NJ",
            "license": "25MB09229100",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NJ",
            "license": "25MB09229100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Sophia Labreck
• Melody A Laranjeira, M.S., CCC-SLP
• Heather M Laughland, ANP-BC, APN
• Lauren Antonison Wellness LLC
• Brandie Legion
• Jennifer L Liao, M.D.
• Steven Andrew Litz, MD
• Live to Thrive Inc.
• Living Sanctuary 1 Health Care Services
• Living Sanctuary Health Care Services

• Physical Medicine & Rehabilitation Physician in West Deptford, NJ
• Providers in West Deptford, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.