NPIMap

Individual provider Active NPI

Lee Thomas Church, M.D.

  • Hospitalist Physician
  • Winnemucca, NV
National Provider Identifier
1235428889
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
64526 Issued in MN
Practice address
118 E Haskell St
Winnemucca, NV 89445-3299
Phone
(775) 623-5222
NPI assigned
Apr 5, 2011
Last updated
May 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 16373 NV
Emergency Medicine Physician 207P00000X 64526 MN
Family Medicine Physician 207Q00000X 64526 MN
Family Medicine Physician 207Q00000X 16373 NV
Hospitalist Physician 208M00000X 64526 MN Primary
Hospitalist Physician 208M00000X 16373 NV

Addresses

Primary practice location

118 E Haskell St
Winnemucca, NV 89445-3299

Mailing address

PO Box 143
Cohasset, MN 55721-0143

Other practice location 1

4700 Las Vegas Blvd N
4700 Las Vegas Blvd N
Nellis AFB, NV 89191-6600
Phone (702) 653-8277

Other practice location 2

115 10th Ave NE
Deer River, MN 56636-8795
Phone (218) 246-2900

Other practice location 3

60MDG/Sgof
101 Bodin Cir
Travis AFB, CA 94535-1800
Phone (218) 259-8740

Other identifiers 1

IdentifierTypeStateIssuer
1235428889MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, MN2 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
I20160617001273 NV Practitioner - Family Practice 1759508740 Reassigns benefits to 3 organizations
I20181224000096 MN Practitioner - HospitalistPractitioner - Family PracticePractitioner - Internal Medicine 1759508740 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Family Practice
Education
University of Minnesota Medical School, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacial Ridge Hospital DistrictGroup PAC ID 5294789194, shared by 7 NPIs, 69 clinicians
Deer River Healthcare Center IncGroup PAC ID 1850388448, 14 clinicians
Humboldt General HospitalGroup PAC ID 5193709798, shared by 5 NPIs, 41 clinicians

Practice addresses (Care Compare)

10 4TH Ave SE
Glenwood, MN 56334-1820
Phone (320) 634-4521

115 10TH Ave NE
Deer River, MN 56636-8795

118 E Haskell St
Winnemucca, NV 89445-3247
Phone (775) 623-5222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16373CAMDSocial Worker
16373NVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Glacial Ridge Hospital District CurrentSince May 1, 2025 Accepting new patients
Deer River Healthcare Center, Inc. CurrentSince Aug 15, 2022 Accepting new patients
Deer River Healthcare Center, Inc. Current Accepting new patients
The Duluth Clinic, LTD. CurrentSince Aug 15, 2022 Accepting new patients
The Duluth Clinic LTD CurrentSince Aug 15, 2022 Accepting new patients
Glacial Ridge Hospital District Family Medicine Current Accepting new patients
Deer River Healthcare Center, Inc CurrentSince Aug 15, 2022 Accepting new patients
Glacial Ridge Hospital District Current Accepting new patients
Humboldt General Hospital CurrentSince Jan 9, 2024 Accepting new patients
Humboldt General Hospital Current Accepting new patients
Winnemucca Emergency Physicians LLC Emergency Medicine CurrentSince Mar 6, 2025 Accepting new patients
Ely-Bloomenson Community Hospital CurrentSince Aug 1, 2025 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients
Humboldt General Hospital CurrentSince Jan 9, 2024 Accepting new patients
Ely-Bloomenson Community Hospital CurrentSince Aug 1, 2025 Accepting new patients
Rural Physicians Group-Pannu PLLC Family Medicine Past Accepting new patients

Locations

115 10th Ave NE
Deer River, MN 56636
Phone (218) 246-2900

115 10th Ave NE
#A
Deer River, MN 56636
Phone (218) 246-8275

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

328 W Conan St
Ely, MN 55731
Phone (218) 365-3271

10 4th Ave SE
Glenwood, MN 56334
Phone (320) 634-5157

417 Franklin St S
Glenwood, MN 56334
Phone (320) 634-5157

118 E Haskell St
Winnemucca, NV 89445
Phone (775) 623-5222

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/glac-1755385c

Organizations & group practices 16

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.

View all 16

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1235428889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 143",
            "city": "COHASSET",
            "state": "MN",
            "postal_code": "557210143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 E HASKELL ST",
            "city": "WINNEMUCCA",
            "state": "NV",
            "postal_code": "894453299",
            "telephone_number": "775-623-5222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4700 Las Vegas Blvd N",
            "address_2": "4700 Las Vegas Blvd N",
            "address_purpose": "LOCATION",
            "city": "Nellis AFB",
            "state": "NV",
            "postal_code": "891916600",
            "country_code": "US",
            "telephone_number": "702-653-8277",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 10th Ave NE",
            "address_purpose": "LOCATION",
            "city": "Deer River",
            "state": "MN",
            "postal_code": "566368795",
            "country_code": "US",
            "telephone_number": "218-246-2900",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60MDG/SGOF",
            "address_2": "101 Bodin Cir",
            "address_purpose": "LOCATION",
            "city": "Travis AFB",
            "state": "CA",
            "postal_code": "945351800",
            "country_code": "US",
            "telephone_number": "218-259-8740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHURCH",
        "first_name": "LEE",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-05",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "16373",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "64526",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "64526",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NV",
            "license": "16373",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MN",
            "license": "64526",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "NV",
            "license": "16373",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235428889",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winnemucca, NV

Sources for this page

Verify at the official NPI Registry.