NPIMap

Organization Active NPI

Lee Obstetrics & Gynecology, PC

  • Medical Specialty Clinic/Center
  • Auburn, AL
National Provider Identifier
1033170238
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
LEE OBSTETRICS & GYNECOLOGY, PC
Practice address
2375 Champions Blvd
Auburn, AL 36830-6471
Phone
(334) 745-6447
Fax
(334) 742-0713
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Jonathan Mahram, M.D.NPI 1366978306
Title
Managing Partner
Phone
(334) 745-6447

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

2375 Champions Blvd
Auburn, AL 36830-6471

Mailing address

2375 Champions Blvd
Auburn, AL 36830-6471
Phone (334) 745-6447

Other identifiers 1

IdentifierTypeStateIssuer
528501030MedicaidAL

Other names 1

  • Lee Ob/Gyn Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051130000482 AL Part B Supplier - Clinic/Group Practice 4880614270 Receives reassigned benefits from 11 practitioners
Practice locations: Auburn, AL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
01D0306338Lee Obstetrics & Gynecology2375 Champions Blvd, 2ND Floor, Auburn, AL 36830Provider-performed microscopySep 21, 2027

National Provider Directory

National Provider Directory

Locations

2375 Champions Blvd
Ste 2
Auburn, AL 36830
Phone (334) 745-6447

121 N 20th St
Ste 2
Opelika, AL 36801
Phone (334) 528-2404

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1033170238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2375 CHAMPIONS BLVD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306471",
            "telephone_number": "334-745-6447",
            "fax_number": "334-742-0713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2375 CHAMPIONS BLVD",
            "city": "AUBURN",
            "state": "AL",
            "postal_code": "368306471",
            "telephone_number": "334-745-6447",
            "fax_number": "334-742-0713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE OBSTETRICS & GYNECOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "MAHRAM",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "334-745-6447",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "528501030",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee Ob/Gyn",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Lee Ob/Gyn",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Auburn, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.