Individual provider Active NPI

Jeremy James Lee, D.C., A.T.C.

  • Chiropractor
  • Geneseo, NY
National Provider Identifier
1356332605
Registry record updated Jul 28, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
X011060 Issued in NY
Practice address
131 Main St
Geneseo, NY 14454-1242
Phone
(585) 447-2775
Fax
(585) 286-3100
NPI assigned
Nov 3, 2005
Last updated
Jul 28, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X X011060 NY Primary
Chiropractor 111N00000X 3263 SC
Chiropractor 111N00000X 006-0001156 VT
Athletic Trainer 2255A2300X 060102433 NY

Addresses

Primary practice location

131 Main St
Geneseo, NY 14454-1242

Mailing address

72 North St
Geneseo, NY 14454-1117
Phone (585) 447-2775

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050808000295 NY Practitioner - Chiropractic 6103855416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
New York Chiropractic College, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

72 E S St
Geneseo, NY 14454-1372
Phone (585) 447-2775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
X011060NYMDChiropractor
006-0001156VTMDChiropractor
060102433NYMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Chiropractic & Athletic Training PLLC CurrentSince Oct 26, 2012 Accepting new patients

Locations

72 E South St
Geneseo, NY 14454
Phone (585) 447-2775

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, 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": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280275200000",
    "number": "1356332605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 NORTH ST",
            "city": "GENESEO",
            "state": "NY",
            "postal_code": "144541117",
            "telephone_number": "585-447-2775",
            "fax_number": "585-286-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "131 MAIN ST",
            "city": "GENESEO",
            "state": "NY",
            "postal_code": "144541242",
            "telephone_number": "585-447-2775",
            "fax_number": "585-286-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEREMY",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C., A.T.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2010-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X011060",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "3263",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VT",
            "license": "006-0001156",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "060102433",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Geneseo, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.