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Deactivated NPI 1417955592 Deactivated / Inactive NPI Male Practitioner

Russell A Lewis , RN

Contractor • Rincon, GA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Russell Lewis has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 12, 2005
NPI Deactivation Date November 15, 2023
Total Practice Duration ~18 Years of Practice (2005 – 2023)

Professional Overview & Biography Verified Profile Summary

Russell Lewis, RN was a registered Contractor practicing in Rincon, GA. Throughout an active medical career spanning 18 years, Russell Lewis provided care at the practice location at 108 KATIE DR until profile deactivation on 2023-11-15.

Practice Location & Contact Primary Location

Practice Address

108 Katie Dr

Rincon, GA 313265708

Telephone 9128264170
Fax 9128263595
Associated Practice Facility / Clinic
🏢 Lewis Medical Supply Llc Facility NPI 1619165263

Specialty Benchmarks & Practice Insights

Comparative analytics for Contractor in Rincon, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 17.2 Yrs
Regional Practice Density
2 Specialists

Practicing in Rincon, GA (727 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Contractor Primary Specialty

NUCC Taxonomy Code: 171W00000X

State License GA 2090

A person who contracts to supply certain materials or do certain work for a stipulated sum; esp., one whose business is contracting work in any of the building trades. For purposes of the taxonomy, a person who contracts to complete home repairs or modifications to accommodate a health condition (e.g. wheelchair ramp, kitchen counter lowering).

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated November 15, 2023

Record deactivated on November 15, 2023

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 108 KATIE DR, RINCON, GA 313265708 (Tel: 9128264170)

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Updated Business Mailing Address July 09, 2007

Registered at 108 KATIE DR, RINCON, GA 313265708 (Tel: 9128264170)

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Provider Name / Credentials Updated July 09, 2007

Recorded as RUSSELL LEWIS, RN

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Contractor (License #2090 in GA)

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Initial NPI Registration & Enumeration July 12, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1417955592
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 12, 2005
Last Update: July 09, 2007
Deactivation Date: November 15, 2023

Mailing Address

108 Katie Dr

Rincon, GA 313265708

Phone: 9128264170

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.