Individual provider Active NPI

Fan Lee

  • Obstetrics & Gynecology Physician
  • Chapel Hill, NC
National Provider Identifier
1316394620
Registry record updated Oct 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
MD481801 Issued in PA
Practice address
101 Manning Drive
Chapel Hill, NC 27514
Phone
(360) 464-8318
NPI assigned
May 17, 2016
Last updated
Oct 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 218044 NC
Obstetrics & Gynecology Physician 207V00000X MD481801 PA Primary

Addresses

Primary practice location

101 Manning Drive
Chapel Hill, NC 27514

Mailing address

4108 Henderson Blvd SE
Olympia, WA 98501-4247
Phone (360) 464-8318

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20231031000662 PA Practitioner - Obstetrics/Gynecology 7416248356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Washington School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jefferson University PhysiciansGroup PAC ID 7911819180, 1,528 clinicians

Practice addresses (Care Compare)

1101 Chestnut St
Philadelphia, PA 19107-3619
Phone (800) 533-3669

111 S 11TH St
Philadelphia, PA 19107-4824

925 Chestnut St
Suite 3
Philadelphia, PA 19107-4216
Phone (215) 955-8874

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218044NCMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Jefferson University Physicians Obstetrics & Gynecology CurrentSince Aug 14, 2023 Accepting new patients
Thomas Jefferson University Hospitals Inc Past Accepting new patients
Jefferson Radiation Oncology, LLC Past Accepting new patients

Locations

1101 Market St
Fl 19
Philadelphia, PA 19107
Phone (215) 481-6836

801 Arch St
Philadelphia, PA 19107
Phone (215) 238-9831

833 Chestnut St
Fl 1
Philadelphia, PA 19107
Phone (215) 955-5000

925 Chestnut St
Fl 6
Philadelphia, PA 19107
Phone (215) 955-6760

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

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": "1463443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698019200000",
    "number": "1316394620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4108 HENDERSON BLVD SE",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985014247",
            "telephone_number": "360-464-8318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DRIVE",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "27514",
            "telephone_number": "360-464-8318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "FAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-17",
        "last_updated": "2023-10-23",
        "certification_date": "2023-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "218044",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD481801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.