Individual provider Active NPI

Vernon Yj Lee, DO PC

  • Family Medicine Physician
  • Thornton, CO
National Provider Identifier
1164511754
Registry record updated Dec 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
COLO18181 Issued in CO
Practice address
9141 Grant St
Suite 245
Thornton, CO 80229
Phone
(303) 252-0550
Fax
(303) 252-9493
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X COLO18181 CO Primary

Addresses

Primary practice location

9141 Grant St
Suite 245
Thornton, CO 80229

Mailing address

9141 Grant St
Suite 245
Thornton, CO 80229
Phone (303) 252-0550

Other identifiers 1

IdentifierTypeStateIssuer
01181072MedicaidCO

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)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
18181COMDPharmacist
COLO18181COMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291334400000",
    "number": "1164511754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9141 GRANT ST",
            "address_2": "SUITE 245",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80229",
            "telephone_number": "303-252-0550",
            "fax_number": "303-252-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9141 GRANT ST",
            "address_2": "SUITE 245",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "80229",
            "telephone_number": "303-252-0550",
            "fax_number": "303-252-9493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "VERNON",
        "middle_name": "YJ",
        "credential": "DO PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2010-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "COLO18181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01181072",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thornton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2010; 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.