Individual provider Active NPI

Jenna Renee Lee, MD

  • Family Medicine Physician
  • Monona, WI
National Provider Identifier
1396449104
Registry record updated Jun 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
87530 Issued in WI
Practice address
1050 E Broadway
Monona, WI 53716-4023
Phone
(608) 222-8779
NPI assigned
Mar 27, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 87530 WI Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

1050 E Broadway
Monona, WI 53716-4023

Mailing address

1050 E Broadway
Monona, WI 53716-4023
Phone (608) 222-8779

Other practice location 1

920 Madison Ave Ste 447
Memphis, TN 38103-3438
Phone (615) 396-6454

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230628001704 TN Order and Referring Only - Family PracticePractitioner - Family Practice 4880052554

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782000000000",
    "number": "1396449104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E BROADWAY",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537164023",
            "telephone_number": "608-222-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E BROADWAY",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537164023",
            "telephone_number": "608-222-8779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Madison Ave Ste 447",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381033438",
            "country_code": "US",
            "telephone_number": "615-396-6454",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JENNA",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2026-06-21",
        "certification_date": "2026-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "87530",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.