Individual provider Active NPI

Susan Lee, M.D.

  • Obstetrics & Gynecology Physician
  • Statesville, NC
National Provider Identifier
1306200175
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
2020-00727 Issued in NC
Practice address
1446 Fern Creek Dr
Statesville, NC 28625-9376
Phone
(704) 873-9617
NPI assigned
Apr 7, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 2020-00727 NC Primary

Addresses

Primary practice location

1446 Fern Creek Dr
Statesville, NC 28625-9376

Mailing address

PO Box 1845
Statesville, NC 28687-1845
Phone (704) 873-4277

Other practice location 1

288 S Ridgecrest Ave Ste 1
Rutherfordton, NC 28139-2838
Phone (828) 286-5583

Other practice location 2

720 Westview Dr SW
Atlanta, GA 30310-1458
Phone (404) 616-1692

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200805002543 NC Practitioner - Obstetrics/Gynecology 0345536637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Minnesota Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Healthcare PAGroup PAC ID 9638070683, 226 clinicians

Practice addresses (Care Compare)

1446 Fern Creek Dr
Statesville, NC 28625-9376
Phone (704) 873-9617

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-00727NCMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Piedmont Healthcare, PA CurrentSince Nov 6, 2023 Accepting new patients
Piedmont Healthcare, P.a. Obstetrics & Gynecology CurrentSince Nov 6, 2023 Accepting new patients
DLP Rutherford Physician Practices LLC Past Accepting new patients

Locations

650 Signal Hill Drive Ext
Statesville, NC 28625
Phone (704) 873-4277

1446 Fern Creek Dr
Statesville, NC 28625
Phone (704) 873-9617

208 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-8215

1424 Fern Creek Dr
#B
Statesville, NC 28625
Phone (704) 662-9870

Interoperability endpoints

  • Direct secure messaging: susanlee@phc.allscriptsdirect.net

Organizations & group practices 3

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": "1459987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1306200175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1845",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286871845",
            "telephone_number": "704-873-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1446 FERN CREEK DR",
            "city": "STATESVILLE",
            "state": "NC",
            "postal_code": "286259376",
            "telephone_number": "704-873-9617"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "288 S Ridgecrest Ave Ste 1",
            "address_purpose": "LOCATION",
            "city": "Rutherfordton",
            "state": "NC",
            "postal_code": "281392838",
            "country_code": "US",
            "telephone_number": "828-286-5583",
            "fax_number": "828-286-5584",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "720 Westview Dr SW",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303101458",
            "country_code": "US",
            "telephone_number": "404-616-1692",
            "fax_number": "404-616-4131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "SUSAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-07",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NC",
            "license": "2020-00727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesville, NC

Sources for this page

Verify at the official NPI Registry.