Individual provider Active NPI

Carmelia Maria Lee, NP

  • Family Nurse Practitioner
  • Deland, FL
National Provider Identifier
1053784983
Registry record updated May 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9334523 Issued in FL
Practice address
2370 E International Speedway Blvd
Deland, FL 32724
Phone
(386) 736-1105
Fax
(386) 734-1443
NPI assigned
Oct 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9334523 FL Primary

Addresses

Primary practice location

2370 E International Speedway Blvd
Deland, FL 32724

Mailing address

2370 E International Speedway Blvd
Deland, FL 32724-2744
Phone (386) 736-1105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161119000478 FL Practitioner - Nurse Practitioner 9032498761 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Med Equity Partners, LLC CurrentSince Jun 28, 2024 Accepting new patients

Locations

2370 E International Speedway Blvd
Deland, FL 32724
Phone (386) 735-1105

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DBEGDD/Endpoint/DBEGDD

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.

NPI Registry JSON

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

{
    "created_epoch": "1446163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526601600000",
    "number": "1053784983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2370 E INTERNATIONAL SPEEDWAY BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "327242744",
            "telephone_number": "386-736-1105",
            "fax_number": "386-734-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2370 E INTERNATIONAL SPEEDWAY BLVD",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "32724",
            "telephone_number": "386-736-1105",
            "fax_number": "386-734-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CARMELIA",
        "middle_name": "MARIA",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-30",
        "last_updated": "2018-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9334523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.