Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dornel J Lewis, NURSEPRACTITIONER

Individual provider Nurse Practitioner · NPI 1861462624

Dornel J Lewis, NURSEPRACTITIONER is a Nurse Practitioner in Ellenwood, Georgia. Qualified in 2019, 7 years ago. Practices as a sole proprietor. Licensed in Georgia.

Years since qualifying
7
Licensed in
GA
In the registry since
2006
Specialties on file
3

Practice location Address checks out

2808 E Atlanta Rd Ste 344
Ellenwood, GA 30294-2780
Phone: (404) 434-0401
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN248615 (GA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence RN248615 (GA)
Registered Nurse Taxonomy 163W00000X · Licence RN248615 (GA)

Record details

NPI number1861462624
Entity typeIndividual (Type 1)
GenderMale
Credentials NURSEPRACTITIONER
Sole proprietorYes
NPI enumeratedJanuary 25, 2006
Last updated in NPPESDecember 19, 2025
Certification dateDecember 19, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Ellenwood