Active NPI
Michael Joseph Lee
- Psychologist
- Charlotte, NC
National Provider Identifier
1215368758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- Practice address
- 6845 Fairview Rd # 26
Charlotte, NC 28210-3363 - Phone
- (704) 266-2219
- NPI assigned
- Dec 10, 2013
- Last updated
- Sep 13, 2022
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | NU | Primary |
Addresses
Primary practice location
6845 Fairview Rd # 26
Charlotte, NC 28210-3363
Mailing address
6845 Fairview Rd # 26
Charlotte, NC 28210-3363
Phone (704) 266-2219
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1386633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663027200000",
"number": "1215368758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6845 FAIRVIEW RD # 26",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103363",
"telephone_number": "704-266-2219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6845 FAIRVIEW RD # 26",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103363",
"telephone_number": "704-266-2219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MICHAEL",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-12-10",
"last_updated": "2022-09-13",
"certification_date": "2022-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.