Active NPI
Joan Odetta Lee
- Nursing Home Administrator
- Miami Gardens, FL
National Provider Identifier
1033862347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Home Administrator
- Practice address
- 1765 NW 189TH Ter
Miami Gardens, FL 33056-3334 - Phone
- (305) 303-1219
- NPI assigned
- Jan 27, 2022
- 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 |
|---|---|---|---|---|
| Nursing Home Administrator | 376G00000X | FL | Primary |
Addresses
Primary practice location
1765 NW 189TH Ter
Miami Gardens, FL 33056-3334
Mailing address
1765 NW 189TH Ter
Miami Gardens, FL 33056-3334
Phone (305) 303-1219
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 686664696 | Medicaid | FL |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643241600000",
"number": "1033862347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1765 NW 189TH TER",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330563334",
"telephone_number": "305-303-1219",
"fax_number": "305-503-7096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1765 NW 189TH TER",
"city": "MIAMI GARDENS",
"state": "FL",
"postal_code": "330563334",
"telephone_number": "305-303-1219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOAN",
"middle_name": "ODETTA",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-27",
"last_updated": "2022-01-27",
"certification_date": "2022-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "376G00000X",
"taxonomy_group": "",
"desc": "Nursing Home Administrator",
"state": "FL",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "686664696",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Miami Gardens, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.