Individual provider Active NPI

Vickie Kyuran Lee, M.D.

  • Allergy Physician
  • Ashburn, VA
National Provider Identifier
1346423381
Registry record updated Aug 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
0101242747 Issued in VA
Practice address
44320 Premier PLZ
Suite #110
Ashburn, VA 20147-5076
Phone
(703) 723-8727
Fax
(703) 723-9787
NPI assigned
Dec 13, 2007
Last updated
Aug 25, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 0101242747 VA Primary

Addresses

Primary practice location

44320 Premier PLZ
Suite #110
Ashburn, VA 20147-5076

Mailing address

44320 Premier PLZ
Suite #110
Ashburn, VA 20147-5076
Phone (703) 723-8727

Other identifiers 5

IdentifierTypeStateIssuer
952108OtherVAAETNA
D393-0001OtherVACAREFIRST BCBS
1346423381MedicaidVA
3179242OtherVAONENET
4569213OtherVACIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20080710000066 VA Practitioner - Allergy/ImmunologyPractitioner - Internal Medicine 9739251638 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Allergy/ImmunologyAlso: Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centers for Advanced ENT Care LLCGroup PAC ID 1658647359, 103 clinicians

Practice addresses (Care Compare)

14000 Crown CT
Suite 201
Woodbridge, VA 22193-1463
Phone (703) 499-8787

44320 Premier PLZ
Suite 110
Ashburn, VA 20147-5077
Phone (703) 723-8727

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101242747VAMDAllergy Physician

Practice roles

OrganizationSpecialtyStatusNew patients
ENT & Allergy Specialists of Virginia PC Allergy CurrentSince Apr 21, 2008 Accepting new patients
Centers for Advanced ENT Care, LLC CurrentSince Jun 1, 2024 Accepting new patients
Cumberland Valley ENT Consultants Past Accepting new patients

Locations

44320 Premier Plz
Ste 110
Ashburn, VA 20147
Phone (703) 229-2373

14000 Crown Ct
Ste 201
Woodbridge, VA 22193
Phone (703) 499-8787

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.

NPI Registry JSON

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

{
    "created_epoch": "1197504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219622400000",
    "number": "1346423381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44320 PREMIER PLZ",
            "address_2": "SUITE #110",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475076",
            "telephone_number": "703-723-8727",
            "fax_number": "703-723-9787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44320 PREMIER PLZ",
            "address_2": "SUITE #110",
            "city": "ASHBURN",
            "state": "VA",
            "postal_code": "201475076",
            "telephone_number": "703-723-8727",
            "fax_number": "703-723-9787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "VICKIE",
        "middle_name": "KYURAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-13",
        "last_updated": "2008-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "VA",
            "license": "0101242747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "952108",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "D393-0001",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1346423381",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONENET",
            "identifier": "3179242",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4569213",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ashburn, VA

Sources for this page

Verify at the official NPI Registry.