NPIMap

Organization Active NPI

Robert J. Lee, M.D., PC

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
National Provider Identifier
1356500086
Registry record updated Sep 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
M7277 Issued in ID
Legal business name
ROBERT J. LEE, M.D., PC
Practice address
3446 S 15TH E
Idaho Falls, ID 83404-8262
Phone
(208) 522-4409
Fax
(208) 522-4497
NPI assigned
Jun 6, 2008
Last updated
Sep 11, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2010

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

Authorized official

Name
Dr. Robert Jensen Lee, M.D.
Title
Owner
Phone
(208) 522-4409

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X M7277 ID Primary

Addresses

Primary practice location

3446 S 15TH E
Idaho Falls, ID 83404-8262

Mailing address

PO Box 1583
Idaho Falls, ID 83403-1583
Phone (208) 522-4409

Other identifiers 5

IdentifierTypeStateIssuer
1356500086OtherIDGROUP NPI
135650086001MedicaidID
1710985551001MedicaidID
135650086002MedicaidID
1710985551OtherIDINDIVIDUAL NPI

National Provider Directory

National Provider Directory

Locations

1443 Parkway Dr
Ste 1
Blackfoot, ID 83221
Phone (208) 522-6335

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284163200000",
    "number": "1356500086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1583",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834031583",
            "telephone_number": "208-522-4409",
            "fax_number": "208-522-4497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3446 S 15TH E",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834048262",
            "telephone_number": "208-522-4409",
            "fax_number": "208-522-4497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT J. LEE, M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-06",
        "last_updated": "2010-09-11",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "JENSEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-522-4409",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "ID",
            "license": "M7277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "1356500086",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135650086001",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1710985551001",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "135650086002",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1710985551",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Idaho Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.