Individual provider Active NPI

Danielle Eden Lee, MD

  • Pediatrics Physician
  • Memphis, TN
National Provider Identifier
1063918340
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0000063315 Issued in TN
Practice address
2860 Covington Pike
Memphis, TN 38128-8090
Phone
(901) 252-6034
NPI assigned
Apr 4, 2018
Last updated
Jul 1, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 0000063315 TN Primary

Addresses

Primary practice location

2860 Covington Pike
Memphis, TN 38128-8090

Mailing address

1999 Linden Ave
Memphis, TN 38104-4132
Phone (901) 674-1482

Other practice location 1

920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (901) 287-6576

Other names 1

  • Danielle Smith Former name

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230530000828 TN Practitioner - Pediatric Medicine 9739438722 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0000063315TNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Meharry Health Network, PC CurrentSince Jul 15, 2023 Accepting new patients
Raleigh Group P.C. Pediatrics PastSince Jul 4, 2021 Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

438 N Cleveland St
Memphis, TN 38104
Phone (866) 364-8944

330 Wallace Rd
Nashville, TN 37211
Phone (866) 378-5362

Interoperability endpoints

  • Direct secure messaging: danielle.lee@wwmp.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/CFJJDD/Endpoint/CFJJDD

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, 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": "1522800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1063918340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1999 LINDEN AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381044132",
            "telephone_number": "901-674-1482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 COVINGTON PIKE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381288090",
            "telephone_number": "901-252-6034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Madison Ave Ste 447",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033438",
            "country_code": "US",
            "telephone_number": "901-287-6576",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "DANIELLE",
        "middle_name": "EDEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-04",
        "last_updated": "2021-07-01",
        "certification_date": "2021-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TN",
            "license": "0000063315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIELLE",
            "last_name": "SMITH",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.