Individual provider Active NPI

Benjamin Michael Lee, O.D.

  • Optometrist
  • Clarksville, TN
National Provider Identifier
1063151223
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3739 Issued in TN
Practice address
2699 Townsend CT
Clarksville, TN 37043-6487
Phone
(931) 647-8417
Fax
(931) 648-4435
NPI assigned
Jun 3, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 3739 TN Primary

Addresses

Primary practice location

2699 Townsend CT
Clarksville, TN 37043-6487

Mailing address

2699 Townsend CT
Clarksville, TN 37043-6487
Phone (931) 647-8417

Other practice location 1

3929 Lamar Dr Ste B
Clarksville, TN 37040-7355
Phone (931) 245-3937

Other identifiers 1

IdentifierTypeStateIssuer
3739OtherTNLICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221020003434 TN Practitioner - Optometry 8628444320 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lynn and York Optometrists PCGroup PAC ID 5395837926, 5 clinicians

Practice addresses (Care Compare)

2699 Townsend CT
Clarksville, TN 37043-6487
Phone (931) 647-8417

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3739TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Lynn & York, Optometrists, PC Optometrist CurrentSince Jul 12, 2022 Accepting new patients

Locations

2699 Townsend Ct
Clarksville, TN 37043
Phone (931) 647-8417

3929 Lamar Dr
Ste B
Clarksville, TN 37040
Phone 9312453937 ext. 203

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1063151223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2699 TOWNSEND CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436487",
            "telephone_number": "931-647-8417",
            "fax_number": "931-648-4435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2699 TOWNSEND CT",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436487",
            "telephone_number": "931-647-8417",
            "fax_number": "931-648-4435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3929 Lamar Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370407355",
            "country_code": "US",
            "telephone_number": "931-245-3937",
            "fax_number": "931-647-0354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "BENJAMIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "TN",
            "license": "3739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "3739",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

Verify at the official NPI Registry.