Individual provider Active NPI

Olajumoke Motunrayo Lee, RN

  • Registered Nurse
  • Endicott, NY
National Provider Identifier
1093558041
Registry record updated Jun 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
768522 Issued in NY
Practice address
2653 Laguna Dr
Endicott, NY 13760-7216
Phone
(607) 296-1281
NPI assigned
Jun 17, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163W00000X 768522 NY Primary

Addresses

Primary practice location

2653 Laguna Dr
Endicott, NY 13760-7216

Mailing address

832 Prescott Ave
Endicott, NY 13760-1761
Phone (845) 671-6611

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
768522NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1718582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718582400000",
    "number": "1093558041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "832 PRESCOTT AVE",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137601761",
            "telephone_number": "845-671-6611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2653 LAGUNA DR",
            "city": "ENDICOTT",
            "state": "NY",
            "postal_code": "137607216",
            "telephone_number": "607-296-1281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "OLAJUMOKE",
        "middle_name": "MOTUNRAYO",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-17",
        "last_updated": "2024-06-17",
        "certification_date": "2024-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "768522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Endicott, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2024; 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.