Active NPI
Lee Whitney Roof, MD
- Internal Medicine Physician
- Coupeville, WA
National Provider Identifier
1407891666
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- M000018926
- Practice address
- 77 North Main St
Coupeville, WA 98239 - Phone
- (360) 678-4440
- Fax
- (360) 678-9244
- NPI assigned
- Jun 19, 2006
- 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 |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | M000018926 | WA | Primary |
Addresses
Primary practice location
77 North Main St
Coupeville, WA 98239
Mailing address
PO Box 746
Coupeville, WA 98239
Phone (360) 678-4440
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9239923 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M000018926 | WA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150675200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1258416000000",
"number": "1407891666",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 746",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "98239",
"telephone_number": "360-678-4440",
"fax_number": "360-678-9244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 NORTH MAIN ST",
"city": "COUPEVILLE",
"state": "WA",
"postal_code": "98239",
"telephone_number": "360-678-4440",
"fax_number": "360-678-9244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROOF",
"first_name": "LEE",
"middle_name": "WHITNEY",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-19",
"last_updated": "2009-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "M000018926",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9239923",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Coupeville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.