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

Mr. Jacob Dwayne Lewis

Individual provider Non-emergency Medical Transport (VAN) · NPI 1124874607

Mr. Jacob Dwayne Lewis is a Non-emergency Medical Transport (VAN) in Riverdale, Georgia. Practices as a sole proprietor. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

8179 Trace Ct
Riverdale, GA 30274-4318
Phone: (470) 634-2692
Show map & directions

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

Specialties & licences

Non-emergency Medical Transport (VAN) (primary) Taxonomy 343900000X

Record details

NPI number1124874607
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 25, 2024
Last updated in NPPESApril 29, 2024
Certification dateApril 29, 2024
Mailing address1201 W Peachtree St Nw Ste 2625, Atlanta, GA 30309-3499

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