Individual provider Active NPI

Miki Chu Lam Lee, RN, CDCES

  • Diabetes Educator Registered Nurse
  • Irving, TX
National Provider Identifier
1417532276
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diabetes Educator Registered NurseTaxonomy code 163WD0400X
License
267957 Issued in AZ
Practice address
3900 Teleport Blvd Unit 140063
Irving, TX 75014-0017
Phone
(312) 933-0671
NPI assigned
Mar 13, 2021
Last updated
Apr 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 041410077 IL
Diabetes Educator Registered Nurse 163WD0400X 267957 AZ Primary

Addresses

Primary practice location

3900 Teleport Blvd Unit 140063
Irving, TX 75014-0017

Mailing address

PO Box 140063
Irving, TX 75014-0063
Phone (312) 933-0761

Other identifiers 1

IdentifierTypeStateIssuer
000000000MedicaidIL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Miki@thesugarnurse.com Direct

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
267957AZMDDiabetes Educator Registered Nurse
041410077ILMDDiabetes Educator Registered Nurse

Interoperability endpoints

  • Direct secure messaging: miki@thesugarnurse.com

NPI Registry JSON

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

{
    "created_epoch": "1615593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1417532276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 140063",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750140063",
            "telephone_number": "312-933-0761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 TELEPORT BLVD UNIT 140063",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750140017",
            "telephone_number": "312-933-0671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM LEE",
        "first_name": "MIKI",
        "middle_name": "CHU",
        "credential": "RN, CDCES",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-13",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "IL",
            "license": "041410077",
            "primary": false
        },
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "AZ",
            "license": "267957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000000",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Miki@thesugarnurse.com",
            "affiliation": "N",
            "endpointDescription": "PHI Protected Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3900 Teleport Blvd Unit 140063",
            "city": "Irving",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750140017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; 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.