Active NPI
Vivie Shang Lee, PA-C
- Physician Assistant
- Atlanta, GA
National Provider Identifier
1053157776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12447
- Practice address
- 95 Collier Rd NW Ste 4025
Atlanta, GA 30309-1750 - Phone
- (404) 574-5820
- NPI assigned
- Jul 2, 2024
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12447 | GA | Primary |
Addresses
Primary practice location
95 Collier Rd NW Ste 4025
Atlanta, GA 30309-1750
Mailing address
45 La Rue PL NW
Atlanta, GA 30327-4072
Phone (973) 668-2730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Mercer University School of Medicine, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
95 Collier Rd NW
Suite 4025
Atlanta, GA 30309-1750
Phone 4045745820105
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/CJAEAA/Endpoint/CJAEAA
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.
-
- Colon & Rectal Surgery Physician
- Atlanta, GA
- NPI 1316146483
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719878400000",
"number": "1053157776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 LA RUE PL NW",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303274072",
"telephone_number": "973-668-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 COLLIER RD NW STE 4025",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303091750",
"telephone_number": "404-574-5820"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "VIVIE",
"middle_name": "SHANG",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-02",
"last_updated": "2024-07-02",
"certification_date": "2024-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "12447",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.