Individual provider Active NPI

Peter Ping Lee, M.D.

  • Neurology Physician
  • Lagrange, GA
National Provider Identifier
1205828993
Registry record updated Mar 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
051157 Issued in GA
Practice address
300 Medical Dr
Suite 701
Lagrange, GA 30240-4130
Phone
(706) 882-0552
Fax
(706) 882-0599
NPI assigned
Aug 18, 2005
Last updated
Mar 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 051157 GA Primary

Addresses

Primary practice location

300 Medical Dr
Suite 701
Lagrange, GA 30240-4130

Mailing address

300 Medical Dr
Suite 701
Lagrange, GA 30240-4130
Phone (706) 882-0552

Other identifiers 3

IdentifierTypeStateIssuer
000947405CMedicaidGA
015931OtherGABLUE CROSS BLUE SHIELD
DC6803OtherGARAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050106000374 GA Practitioner - Neurology 4981507845 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

300 Medical Dr
Suite 701
Lagrange, GA 30240-4130
Phone (706) 882-0552

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0000000GAMDSchool Counselor
051157GAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Centennial Joint Care Inc CurrentSince Feb 27, 2024 Accepting new patients
Regenerative Joint Clinics LLC CurrentSince Feb 1, 2022 Accepting new patients
Duluth Regenerative and Joint Institute LLC CurrentSince Aug 26, 2019 Accepting new patients
Lagrange Neurology Corporation Neurology CurrentSince Jan 1, 2011 Accepting new patients
Regenerative Joint PT LLC PastSince May 3, 2021 Accepting new patients
Peter Ping Lee MD PC Neurology PastSince Jan 1, 2005 Accepting new patients
Prime Regen Decatur PastSince Sep 1, 2021 Accepting new patients
Neurology Center of West Georgia PC Neurology Past Accepting new patients

Locations

1235 Friendship Rd
Ste 115
Braselton, GA 30517
Phone (770) 679-3090

4181 Pleasant Hill Rd
Ste 150
Duluth, GA 30096
Phone (470) 292-3820

10680 Medlock Bridge Rd
Ste 204
Johns Creek, GA 30097
Phone (470) 292-3820

300 Medical Dr
Ste 701
Lagrange, GA 30240
Phone (706) 882-0552

483 Upper Riverdale Rd SW
Ste F
Riverdale, GA 30274
Phone (470) 895-0610

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/JBBACD/Endpoint/JBBACD

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585180800000",
    "number": "1205828993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "address_2": "SUITE 701",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404130",
            "telephone_number": "706-882-0552",
            "fax_number": "706-882-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "address_2": "SUITE 701",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404130",
            "telephone_number": "706-882-0552",
            "fax_number": "706-882-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PETER",
        "middle_name": "PING",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-18",
        "last_updated": "2020-03-26",
        "certification_date": "2020-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "051157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000947405C",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "015931",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC6803",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

Verify at the official NPI Registry.