Active NPI
Michelle M Lee
- Assisted Living Facility
- Surprise, AZ
National Provider Identifier
1124839162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Assisted Living Facility
- License
- AL13059H
- Practice address
- 17628 W Pershing St
Surprise, AZ 85388-5022 - Phone
- (520) 686-0253
- Fax
- (480) 718-8628
- NPI assigned
- Jan 17, 2025
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | AL13059H | AZ | Primary |
Addresses
Primary practice location
17628 W Pershing St
Surprise, AZ 85388-5022
Mailing address
17628 W Pershing St
Surprise, AZ 85388-5022
Phone (520) 686-0253
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL13059H | AZ | MD | Assisted Living Facility |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1737072000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1737072000000",
"number": "1124839162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17628 W PERSHING ST",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853885022",
"telephone_number": "520-686-0253",
"fax_number": "480-718-8628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17628 W PERSHING ST",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853885022",
"telephone_number": "520-686-0253",
"fax_number": "480-718-8628"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MICHELLE",
"middle_name": "M",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-01-17",
"last_updated": "2025-01-17",
"certification_date": "2025-01-17",
"status": "A"
},
"taxonomies": [
{
"code": "310400000X",
"taxonomy_group": "",
"desc": "Assisted Living Facility",
"state": "AZ",
"license": "AL13059H",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.