Individual provider Active NPI

Jonathan Bum Lee, MD

  • Pediatric Emergency Medicine (Pediatrics) Physician
  • Richmond, VA
National Provider Identifier
1215356514
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Emergency Medicine (Pediatrics) PhysicianTaxonomy code 2080P0204X
License
1215356514 Issued in VA
Practice address
7101 Jahnke Rd
Richmond, VA 23225-4044
Phone
(954) 977-9068
NPI assigned
Apr 15, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Emergency Medicine (Emergency Medicine) Physician 207PP0204X 1215356514 VA
Pediatrics Physician 208000000X 1215356514 VA
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 1215356514 VA Primary

Addresses

Primary practice location

7101 Jahnke Rd
Richmond, VA 23225-4044

Mailing address

505 Porter St Apt 807
Richmond, VA 23224-2321
Phone (703) 868-3787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, DC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171114001003 VA Practitioner - Pediatric Medicine 1951601384 Reassigns benefits to 2 organizations
I20211029000078 DC Practitioner - Pediatric MedicinePractitioner - Emergency Medicine 1951601384 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1215356514VAMDPediatric Emergency Medicine (Emergency Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Associates P.a., P.C. Pediatrics Current Accepting new patients
Emergency Coverage, LLC CurrentSince Aug 1, 2021 Accepting new patients
Childrens Hospital of the Kings Daughters Inc CurrentSince Aug 20, 2017 Accepting new patients
Emergency Medicine Associates P.a., P.C. CurrentSince Jan 1, 2024 Accepting new patients
Emergency Medicine Associates PA CurrentSince Jan 1, 2024 Accepting new patients

Locations

1701 N George Mason Dr
Arlington, VA 22205
Phone (703) 558-5000

817 Volvo Pkwy
Chesapeake, VA 23320
Phone (757) 668-4630

3300 Gallows Rd
Falls Church, VA 22042
Phone (703) 352-9395

9275 Chamberlayne Rd
Mechanicsvlle, VA 23116
Phone (800) 417-0300

601 Childrens Ln
Norfolk, VA 23507
Phone (757) 668-7272

7101 Jahnke Rd
Richmond, VA 23225
Phone (804) 323-1088

1602 Skipwith Rd
Richmond, VA 23229
Phone (804) 289-4500

3960 Virginia Beach Blvd
Ste 101
Virginia Beach, VA 23452
Phone (757) 668-4648

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1215356514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 PORTER ST APT 807",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232242321",
            "telephone_number": "703-868-3787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7101 JAHNKE RD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232254044",
            "telephone_number": "954-977-9068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JONATHAN",
        "middle_name": "BUM",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-06-30",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PP0204X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Pediatric Emergency Medicine",
            "state": "VA",
            "license": "1215356514",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "1215356514",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "VA",
            "license": "1215356514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.