Jennifer Irene Lee, CST

Primary specialty

Surgical AssistantTaxonomy code 246ZC0007X

License

134113 Issued in TX

Practice address

7110 Hunnington Dr
Sanger, TX 76266-7954

Phone

(469) 360-4775

NPI assigned

Jan 24, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Miss Jennifer Irene McCollum Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1327363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1306117247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 DEER RUN DR",
            "city": "SANGER",
            "state": "TX",
            "postal_code": "762666606",
            "telephone_number": "469-360-4775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 HUNNINGTON DR",
            "city": "SANGER",
            "state": "TX",
            "postal_code": "762667954",
            "telephone_number": "469-360-4775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNIFER",
        "middle_name": "IRENE",
        "credential": "CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-24",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZS0410X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Technologist",
            "state": "TX",
            "license": "96705",
            "primary": false
        },
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "TX",
            "license": "134113",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "96705",
            "identifier": "96705",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "MCCOLLUM",
            "middle_name": "IRENE",
            "prefix": "MISS",
            "credential": "CST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgical Assistant in Sanger, TX
• Providers in Sanger, TX by specialty
• Surgical Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.