Johnnie Legrant Lee

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

270227392 Issued in MN

Practice address

4347 4TH Ave S
Minneapolis, MN 55409-2115

Phone

(612) 823-3880

NPI assigned

Aug 26, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1345939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345939200000",
    "number": "1104174085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4347 4TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554092115",
            "telephone_number": "612-823-3880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4347 4TH AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554092115",
            "telephone_number": "612-823-3880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHNNIE",
        "middle_name": "LEGRANT",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-26",
        "last_updated": "2012-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "MN",
            "license": "270227392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny Lee, PHD
• Jessica Lee
• Jill Lunsford Lee, CPNP-AC
• Jison Ellen Lee, L.P.C.
• John H Lee, MD
• Jonathan Edward Lee, DO
• Junho Lee
• Kacia Lee, MD
• Kathy Young Lee
• Kia Lee, MSW, MBA, LICSW

• All providers in Minneapolis, MN
• Adult Care Home Facility in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2012; 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.