Individual provider Active NPI

Valerie Veronica Lee, IDMT

  • Independent Duty Medical Technicians
  • Fairview Heights, IL
National Provider Identifier
1245540772
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Independent Duty Medical TechniciansTaxonomy code 1710I1003X
Practice address
210 N Point Rd
Fairview Heights, IL 62208-2437
Phone
(575) 770-2939
NPI assigned
Oct 18, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Independent Duty Medical Technicians 1710I1003X Primary

Addresses

Primary practice location

210 N Point Rd
Fairview Heights, IL 62208-2437

Mailing address

210 N Point Rd
Fairview Heights, IL 62208-2437
Phone (575) 770-2939

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1245540772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N POINT RD",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082437",
            "telephone_number": "575-770-2939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 N POINT RD",
            "city": "FAIRVIEW HEIGHTS",
            "state": "IL",
            "postal_code": "622082437",
            "telephone_number": "575-770-2939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "VALERIE",
        "middle_name": "VERONICA",
        "name_prefix": "Mrs.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.