SHANELLE LEWIS (NPI# 1003392259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003392259 |
| Entity Type | Individual |
| Full Name | SHANELLE LEWIS |
| Practice Address |
4484 Covington Hwy Decatur GA 30035 |
| Mailing Address |
5910 Shadow Rock Dr Lithonia GA 30058-3232 |
| Practice Telephone | 3473132205 |
| Mailing Telephone | 3473132205 |
| Enumeration Date | 2018-07-11 |
| Last Update Date | 2018-07-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246QL0900X |
Spec/Tech, Pathology Specialization: Laboratory Management |
Technologists, Technicians & Other Technical Service Providers | ||
| Y | 246RP1900X |
Technician, Pathology Specialization: Phlebotomy |
Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NA | NA | 01 |
| Street Address |
4484 COVINGTON HWY |
| City | DECATUR |
| State | GA |
| Zip Code | 30035 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184761561 | Dewanda B. Jacksoon | Counselor | 4484 Covington Hwy, Suite 100a, Decatur, GA 30035-1203 | 2007-02-01 |
| 1215592431 | Ego Ideal, Inc. | Point of Service | 4484 Covington Hwy, Decatur, GA 30035-1203 | 2019-05-02 |
| 1255512521 | Jacquelyn L. Ramsey | Community/Behavioral Health | 4484 Covington Hwy, Suite 100-a, Decatur, GA 30035-1203 | 2007-11-15 |
| 1922145325 | Marvelous Light Consultants | Counselor | 4484 Covington Hwy, Suite 100a, Decatur, GA 30035-1203 | 2007-02-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972079978 | James L Vinson, Phd | Home Health Aide | 4050 Snapfinger Woods Drive, Suite 201, Decatur, GA 30035 | 2018-10-17 |
| 1417445206 | Kamla Gonzales | Nurse Practitioner | 5146 Miller Woods Trl, Decatur, GA 30035 | 2018-04-26 |
| 1578924924 | Alicia Marie Johnson Bryant | Social Worker | 5878 Covington Hwy, Decater, GA 30035 | 2016-03-14 |
| 1568865756 | Tracy Roberson | Counselor | 4150 Snapfinger Woods Drive, Decatur, GA 30035 | 2014-10-01 |
| 1972927861 | Tyrone D. Lane Enterprises, Incorporated | Psychologist | 5304 Panola Industrial Boulevard, Suite L, Decatur, GA 30035 | 2014-02-12 |
| 1013255355 | Mervin E Williams | Pharmacist | 2075 South Hairston, Decatur, GA 30035 | 2013-01-22 |
| 1205187572 | Mariana Simpson-walker | Speech-Language Pathologist | 4262 Clausell Ct Ste A, Decatur, GA 30035 | 2012-09-27 |
| 1053683854 | Jimiesh G Crane | Dentist | 5243 Snapfinger Woods Dr Ste 105, Decatur, GA 30035 | 2012-02-08 |
| 1568765824 | Salih Robinson | Health Educator | 2511 Lantrac Ct, Decatur, GA 30035 | 2010-12-08 |
| 1831428234 | Thomas Counseling | Counselor | 3781 Presidential Parkway, Suite 111c, Chamblee, GA 30035 | 2009-12-14 |
| Find all providers in zip 30035 | ||||
| Taxonomy Code | 246RP1900X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Technician, Pathology |
| Specialization | Phlebotomy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548882186 | Linda M Stricklin | Technician, Pathology | 1622 S Taylorville Rd, Decatur, IL 62521-3951 | 2020-05-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619576485 | Angels Mobile Phlebotomy Services LLC | Technician, Pathology | 185 Kirby Ln, Athens, GA 30606-1683 | 2020-10-22 |
| 1164021101 | Marquetta Nolbert | Technician, Pathology | 665 Castlebrooke Way, Lawrenceville, GA 30045-2665 | 2020-10-21 |
| 1528666518 | Shmeika Wilcox | Technician, Pathology | 3608 Stone Rd Sw, Atlanta, GA 30331-5306 | 2020-10-13 |
| 1972101913 | Revonia Lynn | Technician, Pathology | 4630 Rolling Brook Ct, Union City, GA 30291-6524 | 2020-10-12 |
| 1598362279 | Sheryl White | Technician, Pathology | 574 Scotland Dr, Dallas, GA 30132-2625 | 2020-10-06 |
| 1720685449 | Dominique Hyatt | Technician, Pathology | 1414 Ericas Pointe Dr, Winder, GA 30680-8006 | 2020-10-06 |
| 1922610799 | Mccane Labs LLC | Technician, Pathology | 1546a Rocky Creek Rd Ste A, Macon, GA 31206-3581 | 2020-08-21 |
| 1063036051 | Kianna Tymoria Boone | Technician, Pathology | 608 S Lee St, Fitzgerald, GA 31750-3217 | 2020-06-04 |
| 1568086031 | Antarnisear Brantley | Technician, Pathology | 311 Scott St Sw Apt 118, Atlanta, GA 30311-1814 | 2020-06-01 |
| 1568085330 | Monya Moreland | Technician, Pathology | 1008 Tree Terrace Pkwy, Austell, GA 30168-5544 | 2020-05-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.