NPIMap

Individual provider Active NPI

John Martin Lee Jr., MD

  • Nephrology Physician
  • Tupelo, MS
National Provider Identifier
1205806155
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
10710 Issued in MS
Practice address
1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone
(662) 844-4711
Fax
(662) 844-9619
NPI assigned
Jan 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 10710 MS Primary

Addresses

Primary practice location

1542 Medical Park Cir
Tupelo, MS 38801-6560

Mailing address

1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone (662) 844-4711

Other identifiers 5

IdentifierTypeStateIssuer
00010520MedicaidMS
0114538OtherMSBLUE CROSS BLUE SHIELD MS
10710OtherMSSTATE LIC NUMBER
009002820MedicaidAL
73012088OtherBLUE CROSS BLUE SHIELD/ OTHER STATES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050511000948 AL Practitioner - Nephrology 0840230744
I20110218000616 MS Practitioner - Nephrology 0840230744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
University of Mississippi School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nephrology and Hypertension Associates LTDGroup PAC ID 1254327554, 19 clinicians

Practice addresses (Care Compare)

1542 Medical Park Cir
Tupelo, MS 38801-6560
Phone (662) 844-4711

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North Mississippi Medical Center Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: johnlee@nmhs.medalliesdirect.net
  • Direct secure messaging: jlee30306@direct.acumenmd.com

Organizations & group practices 2

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1205806155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1542 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-4711",
            "fax_number": "662-844-9619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1542 MEDICAL PARK CIR",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016560",
            "telephone_number": "662-844-4711",
            "fax_number": "662-844-9619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JOHN",
        "middle_name": "MARTIN",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MS",
            "license": "10710",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00010520",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MS",
            "identifier": "0114538",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC NUMBER",
            "identifier": "10710",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009002820",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD/ OTHER STATES",
            "identifier": "73012088",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

Verify at the official NPI Registry.