Lin Li, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

ME96974 Issued in FL

Practice address

400 Health Park Blvd
St Augustine, FL 32086-5784

Phone

(904) 824-4990

Fax

(904) 824-2226

NPI assigned

Sep 20, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203292800000",
    "number": "1154429827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3543",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320853543",
            "telephone_number": "904-824-4990",
            "fax_number": "904-824-2226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865784",
            "telephone_number": "904-824-4990",
            "fax_number": "904-824-2226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LI",
        "first_name": "LIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME96974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN NUMBER",
            "identifier": "I68030",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILRAOD MEDICARE",
            "identifier": "P00364189",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Brennan Leyendecker, DPT
• Chung-Li Jason Li, PH.D.
• Melissa Lichty, APRN
• April Heather Liddle, LCSW
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• Anatomic Pathology & Clinical Pathology Physician in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2008; 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.