Individual provider Active NPI

William Luke Lee, MD

  • Emergency Medicine Physician
  • Johnson City, TN
National Provider Identifier
1417965633
Registry record updated Mar 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD24490 Issued in TN
Practice address
400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone
(423) 926-6266
Fax
(423) 926-7599
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD24490 TN Primary

Addresses

Primary practice location

400 N State of Franklin Rd
Johnson City, TN 37604-6035

Mailing address

PO Box 5576
Johnson City, TN 37602-5576
Phone (423) 926-6266

Other identifiers 3

IdentifierTypeStateIssuer
1417965633MedicaidVA
930082032OtherRR MEDICARE
3077758MedicaidTN

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
I20070829000842 TN Practitioner - Emergency Medicine 7416040977 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Tennessee, HSC, College of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tri-Cities Observation Services, PCGroup PAC ID 3274819719, 18 clinicians
Tri-Cities Regional Emergency Physicians, PCGroup PAC ID 3678859477, 118 clinicians

Practice addresses (Care Compare)

400 N State of Franklin Rd
Johnson City, TN 37604-6035
Phone (423) 431-6111

Hospital & facility affiliations

  • Johnson City Medical Center Hospital, Johnson City, TN, CCN 440063

Merit-based Incentive Payment System (MIPS)

Final score
90.33 of 100Reported as group
Quality
83.8
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD24490TNMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Apr 13, 2017 Accepting new patients
Tri-Cities Observation Services, PC Emergency Medicine CurrentSince Dec 13, 2017 Accepting new patients
Johnson City Emergency Physicians, PC Emergency Medicine Past Accepting new patients

Locations

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

Organizations & group practices 3

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299110400000",
    "number": "1417965633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5576",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376025576",
            "telephone_number": "423-926-6266",
            "fax_number": "423-926-7599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N STATE OF FRANKLIN RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046035",
            "telephone_number": "423-926-6266",
            "fax_number": "423-926-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "WILLIAM",
        "middle_name": "LUKE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2011-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "MD24490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417965633",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "930082032",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3077758",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.