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JACQUELINE LEWIS NP
NPI 1093263071
Nurse Practitioner - Family in Ellenwood, GA

Active since September 19, 2016PECOS Enrolled
304 SUMMIT HEIGHTS CT STE 120, ELLENWOOD, GA 30294(404) 552-5128 Get Directions Write a Review

NPPES record last updated: May 5, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: May 5, 2026, Mar 19, 2025, Feb 6, 2021 and 1 more (4 updates tracked since 2016).

About Jacqueline Lewis Np NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACQUELINE LEWIS NP (NPI 1093263071) is an individual family provider in Ellenwood, Georgia, licensed in Georgia (APRN-NP172074) and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS and maintains a secondary practice location in Decatur.

NPPES Registry Identity

NPI1093263071
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJACQUELINE LEWISCredential: NP
Location Address304 SUMMIT HEIGHTS CT STE 120Ellenwood, GA 30294-2973
Mailing AddressPo Box 740015Atlanta, GA 30374-0015 · (312) 773-9730
Phone(404) 552-5128
Sole ProprietorYes
Enumeration DateSeptember 19, 2016
Last NPPES UpdateMay 5, 20264 updates tracked since enumeration
NPPES CertifiedMay 5, 2026
✔ NPI 1093263071 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in GA · APRN-NP172074
Also ListedNurse PractitionerTaxonomy 363L00000X · License RN172074 (GA)
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License APRN-NP172074 (GA)
304 SUMMIT HEIGHTS CT STE 120, Ellenwood, GA 30294
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Secondary Practice Location 1

Location 12732 Candler RdDecatur, GA 30034-1410 · Phone (470) 444-3133 · Fax (470) 276-4051

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jacqueline Lewis Np is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30294 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Care Plan
Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…
100%76 patients5/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacqueline Lewis's NPI number?

The NPI number for Jacqueline Lewis is 1093263071. It was assigned to this individual provider in the NPPES registry on September 19, 2016.

Where is Jacqueline Lewis located?

Jacqueline Lewis practices at 304 Summit Heights Ct Ste 120, Ellenwood, GA 30294. The listed phone number is (404) 552-5128.

What is Jacqueline Lewis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jacqueline Lewis enrolled in Medicare?

Yes. Jacqueline Lewis is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jacqueline Lewis was last updated on May 5, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.