Active NPI
John Lee
- Surgery Physician
- Little Rock, AR
National Provider Identifier
1386402758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 125.085638
- Practice address
- 622 N Tyler St
Little Rock, AR 72205-3531 - Phone
- (501) 773-7509
- NPI assigned
- Mar 11, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 125.085638 | IL | Primary |
Addresses
Primary practice location
622 N Tyler St
Little Rock, AR 72205-3531
Mailing address
622 N Tyler St
Little Rock, AR 72205-3531
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20250530002125 | IL | Order and Referring Only - General Surgery | 8921517178 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125.085638 | IL | MD | Surgery Physician |
Interoperability endpoints
- jlee187521@uihealth.direct-ci.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1710115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747008000000",
"number": "1386402758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "622 N TYLER ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722053531"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "622 N TYLER ST",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722053531",
"telephone_number": "501-773-7509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-03-11",
"last_updated": "2025-05-12",
"certification_date": "2025-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "IL",
"license": "125.085638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2025; 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.