Active NPI
Tina Maria Lee
- Home Modifications Contractor
- Colonial Heights, VA
National Provider Identifier
1205340866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 47-2060180
- Practice address
- 604 James Ave
Colonial Heights, VA 23834-2812 - Phone
- (804) 722-5889
- NPI assigned
- Nov 18, 2017
- 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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 47-2060180 | VA | Primary |
Addresses
Primary practice location
604 James Ave
Colonial Heights, VA 23834-2812
Mailing address
604 James Ave
Colonial Heights, VA 23834-2812
Phone (804) 722-5889
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 |
|---|---|---|---|
| 47-2060180 | VA | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510963200000",
"number": "1205340866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 JAMES AVE",
"city": "COLONIAL HEIGHTS",
"state": "VA",
"postal_code": "238342812",
"telephone_number": "804-722-5889"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 JAMES AVE",
"city": "COLONIAL HEIGHTS",
"state": "VA",
"postal_code": "238342812",
"telephone_number": "804-722-5889"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "TINA",
"middle_name": "MARIA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-18",
"last_updated": "2017-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Contractor, Home Modifications",
"state": "VA",
"license": "47-2060180",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Colonial Heights, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.