Active NPI
Mary Lee, FNP-BC
- Family Nurse Practitioner
- Frisco, CO
National Provider Identifier
1336316181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 113720
- Practice address
- 360 Peak One Drive
Suite 100
Frisco, CO 80443 - Phone
- (970) 668-4040
- NPI assigned
- May 12, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 113720 | CO | Primary |
Addresses
Primary practice location
360 Peak One Drive
Suite 100
Frisco, CO 80443
Mailing address
PO Box 4337
360 CR 1007
Frisco, CO 80443-4337
Phone (970) 668-4047
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 35222581 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 113720 | CO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Swan Mountain Women'S Center, PC | Past | Accepting new patients |
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1210550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1370390400000",
"number": "1336316181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 4337",
"address_2": "360 CR 1007",
"city": "FRISCO",
"state": "CO",
"postal_code": "804434337",
"telephone_number": "970-668-4047"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "360 PEAK ONE DRIVE",
"address_2": "SUITE 100",
"city": "FRISCO",
"state": "CO",
"postal_code": "80443",
"telephone_number": "970-668-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MARY",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-12",
"last_updated": "2013-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CO",
"license": "113720",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "35222581",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Frisco, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.