Individual provider Active NPI

Louis Lee, M.D.

  • Internal Medicine Physician
  • Lithonia, GA
National Provider Identifier
1053409797
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
38840 Issued in GA
Practice address
2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996
Phone
(404) 501-8492
Fax
(404) 501-8645
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X 038840 GA
Internal Medicine Physician 207R00000X 38840 GA Primary

Addresses

Primary practice location

2801 Dekalb Medical Pkwy
Lithonia, GA 30058-4996

Mailing address

PO Box 403631
Atlanta, GA 30384-3631
Phone (770) 740-0895

Other identifiers 2

IdentifierTypeStateIssuer
P00392996OtherGARR MCARE
000675001IMedicaidGA

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

LicenseStateTypeSpecialty
38840GAMDInternal Medicine Physician
038840GAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Medical Hospitalists LLC Hospitalist Past Accepting new patients
Family Care Centers Trust Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1053409797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403631",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303843631",
            "telephone_number": "770-740-0895",
            "fax_number": "770-740-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 DEKALB MEDICAL PKWY",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584996",
            "telephone_number": "404-501-8492",
            "fax_number": "404-501-8645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "LOUIS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "GA",
            "license": "038840",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "38840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCARE",
            "identifier": "P00392996",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000675001I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.