Active NPI
Cenedra Dionne Lee, NP
- Nurse Practitioner
- Jackson, MS
National Provider Identifier
1083012132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R885414
- Practice address
- 2500 North State Street
Jackson, MS 39216-4500 - Phone
- (601) 815-4128
- NPI assigned
- Dec 5, 2014
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R885414 | MS | Primary |
Addresses
Primary practice location
2500 North State Street
Jackson, MS 39216-4500
Mailing address
2500 North State Street
JMM Room 2525
Jackson, MS 39216-4500
Phone (601) 815-4128
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R885414 | MS | MD | Nurse Practitioner |
Interoperability endpoints
- clee59207@ummc.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1417737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1450310400000",
"number": "1083012132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 NORTH STATE STREET",
"address_2": "JMM ROOM 2525",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-815-4128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 NORTH STATE STREET",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-815-4128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CENEDRA",
"middle_name": "DIONNE",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-12-05",
"last_updated": "2015-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R885414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.