Individual provider Active NPI

Marcie Lee, NP-C

  • Nurse Practitioner
  • Hattiesburg, MS
National Provider Identifier
1104243195
Registry record updated Mar 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R834138 Issued in MS
Practice address
51 Brooks Rd
Hattiesburg, MS 39401-8927
Phone
(601) 528-2680
Fax
(443) 662-4230
NPI assigned
Mar 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R834138 MS Primary

Addresses

Primary practice location

51 Brooks Rd
Hattiesburg, MS 39401-8927

Mailing address

51 Brooks Rd
Hattiesburg, MS 39401-8927
Phone (601) 528-2680

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140811000984 MS Practitioner - Nurse Practitioner 7719104017 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The National Diabetes & Obesity Research Institute at Tradition, Missi CurrentSince Apr 1, 2020 Accepting new patients

Locations

19289C Saint Joseph St
Biloxi, MS 39532
Phone (228) 822-6052

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1395878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395878400000",
    "number": "1104243195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 BROOKS RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018927",
            "telephone_number": "601-528-2680",
            "fax_number": "443-662-4230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 BROOKS RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394018927",
            "telephone_number": "601-528-2680",
            "fax_number": "443-662-4230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARCIE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-27",
        "last_updated": "2014-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MS",
            "license": "R834138",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.