Active NPI
Lise G Lee, M.D.
- Pediatrics Physician
- Saint Louis, MO
National Provider Identifier
1023306248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 036.146492
- Practice address
- 1005 Mississippi Ave Unit E
Saint Louis, MO 63104-2475 - Phone
- (608) 345-9957
- NPI assigned
- Jul 21, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 036.146492 | IL | Primary |
Addresses
Primary practice location
1005 Mississippi Ave Unit E
Saint Louis, MO 63104-2475
Mailing address
1005 Mississippi Ave Unit E
Saint Louis, MO 63104-2475
Phone (608) 345-9957
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 |
|---|---|---|---|
| 036.146492 | IL | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nationwide Children'S Hospital | 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 and National Provider Directory roles.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690070400000",
"number": "1023306248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1005 MISSISSIPPI AVE UNIT E",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631042475",
"telephone_number": "608-345-9957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1005 MISSISSIPPI AVE UNIT E",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631042475",
"telephone_number": "608-345-9957"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "LISE",
"middle_name": "G",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-21",
"last_updated": "2023-07-23",
"certification_date": "2023-07-23",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IL",
"license": "036.146492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.