Active NPI
Soong Hyun Lee, M.D.
- Psychiatry Physician
- Charlotte, NC
National Provider Identifier
1013121094
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 17687
- Practice address
- Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009 - Phone
- (704) 358-2700
- Fax
- (704) 358-2716
- NPI assigned
- May 9, 2007
- Last updated
- May 8, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 17687 | NC | Primary |
Addresses
Primary practice location
Behavioral Health Center CMC Randolph
501 Billingsley Road
Charlotte, NC 28211-1009
Mailing address
PO Box 601372
Charlotte, NC 28260-1372
Phone (704) 358-2700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 891174N | Medicaid | NC | |
| NC1014 | Medicaid | SC | |
| 1013121094 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17687 | NC | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolinas Medical Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Charlotte, NC
- NPI 1295789907
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1399507200000",
"number": "1013121094",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601372",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601372",
"telephone_number": "704-358-2700",
"fax_number": "704-358-2716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BEHAVIORAL HEALTH CENTER CMC RANDOLPH",
"address_2": "501 BILLINGSLEY ROAD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111009",
"telephone_number": "704-358-2700",
"fax_number": "704-358-2716"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SOONG",
"middle_name": "HYUN",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-09",
"last_updated": "2014-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "NC",
"license": "17687",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "891174N",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NC1014",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1013121094",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.