Individual provider Active NPI

Peter Yong Joon Lee, MD

  • Psychiatry Physician
  • Austell, GA
National Provider Identifier
1376004473
Registry record updated Oct 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
96346 Issued in GA
Practice address
1625 Hospital North Drive
Suite 150
Austell, GA 30106-8111
Phone
(770) 732-6950
NPI assigned
Mar 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X MD.42146 AL
Student in an Organized Health Care Education/Training Program 390200000X
Psychiatry Physician 2084P0800X 96346 GA Primary

Addresses

Primary practice location

1625 Hospital North Drive
Suite 150
Austell, GA 30106-8111

Mailing address

1625 Hospital North Dr Ste 150
Austell, GA 30106-8111
Phone (470) 732-6950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20220518000830 AL Practitioner - Psychiatry 7810320744 Reassigns benefits to 1 organization
I20230802000262 GA Practitioner - Psychiatry 7810320744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
University of South Alabama College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

1625 Hospital N Dr
Suite 150
Austell, GA 30106-8111
Phone (770) 732-6950

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Altapointe Health Systems, Inc. CurrentSince Apr 22, 2022 Accepting new patients
Wellstar Medical Group, LLC Current Accepting new patients
Wellstar Medical Group, LLC CurrentSince Aug 1, 2023 Accepting new patients
Altapointe Health Systems, Inc. CurrentSince Apr 22, 2022 Accepting new patients
Wellstar Cardiovascular Medicine, LLC PastSince Sep 1, 2023 Accepting new patients

Locations

5750A Southland Dr
Mobile, AL 36693
Phone (251) 450-5901

2400 Gordon Smith Dr
Mobile, AL 36617
Phone (251) 305-4660

2451 University Hospital Dr
Rm 714
Mobile, AL 36617
Phone (251) 445-8282

1625 Hospital North Dr
#150
Austell, GA 30106
Phone (470) 732-6950

1625 Hospital North Dr
Austell, GA 30106
Phone (770) 732-6950

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1553817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696896000000",
    "number": "1376004473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 HOSPITAL NORTH DR STE 150",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068111",
            "telephone_number": "470-732-6950",
            "fax_number": "770-739-0138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 HOSPITAL NORTH DRIVE",
            "address_2": "SUITE 150",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068111",
            "telephone_number": "770-732-6950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PETER",
        "middle_name": "YONG JOON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-29",
        "last_updated": "2023-10-10",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "MD.42146",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "96346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.