Active NPI
Paul Andrew Lee, PA
- Physician Assistant
- Kingsport, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 424
- Practice address
- 2205 Pavilion Dr
Suite 201
Kingsport, TN 37660-4641 - Phone
- (423) 857-7650
- Fax
- (423) 857-7655
- NPI assigned
- Jul 18, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 424 | TN | Primary |
| Physician Assistant | 363A00000X | 0110840851 | VA |
Addresses
Primary practice location
2205 Pavilion Dr
Suite 201
Kingsport, TN 37660-4641
Mailing address
2205 Pavilion Dr
Suite 201
Kingsport, TN 37660-4641
Phone (423) 857-7650
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1511020 | Medicaid | TN | |
| P00698768 | Other | TN | RAILROAD MEDICARE |
| 8923655 | Medicaid | VA | |
| Q003286 | Medicaid | TN | |
| 1447279856 | Medicaid | VA |
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: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1992
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
130 W Ravine Rd
Kingsport, TN 37660-3831
Phone (423) 244-4000
2000 Brookside Dr
Kingsport, TN 37660-4627
Phone (423) 320-5000
2033 Meadowview LN
Kingsport, TN 37660-7569
Phone (423) 230-5000
2050 Meadowview Pkwy
Kingsport, TN 37660-7475
Phone (423) 230-5000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Wellmont Medical Associates, Inc. | Current | Accepting new patients | |
| Blue Ridge Medical Management Corporation | Current | Accepting new patients |
Locations
438 E Vann Rd
Ste 202
Greeneville, TN 37743
Phone (423) 278-1703
111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197
2205 Pavilion Dr
Ste 201
Kingsport, TN 37660
Phone (423) 224-2370
391 Falls Dr NW
Abingdon, VA 24210
Phone (276) 628-4406
16000 Johnston Memorial Dr
Ste 212
Abingdon, VA 24211
Phone (276) 258-2732
1990 Holton Ave E
Big Stone Gap, VA 24219
Phone (276) 523-3111
127 Health Care Dr
Ste 3
Pennington Gap, VA 24277
Phone (276) 299-5000
Organizations & group practices 7
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.
-
- Cardiovascular Disease Physician
- Kingsport, TN
- NPI 1376575035
-
dba First Assist Urgent Care
- Urgent Care Clinic/Center
- Elizabethton, TN
- NPI 1144380833
-
dba Ballad Health Medical Associates
- Pulmonary Disease Physician
- Kingsport, TN
- NPI 1780986257
-
dba Ballad Health Medical Associates
- Internal Medicine Physician
- Johnson City, TN
- NPI 1942520267
-
dba Ballad Health Medical Associates
- Internal Medicine Physician
- Johnson City, TN
- NPI 1154789030
-
dba Ballad Health Medical Associates
- Psychiatry Physician
- Johnson City, TN
- NPI 1275393522
-
dba Ballad Health Medical Associates
- Internal Medicine Physician
- Lebanon, VA
- NPI 1447618335
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Holston Valley Medical Center
- General Acute Care Hospital
- Kingsport, TN
- NPI 1487690400
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487116800000",
"number": "1447279856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2205 PAVILION DR",
"address_2": "SUITE 201",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604641",
"telephone_number": "423-857-7650",
"fax_number": "423-857-7655"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2205 PAVILION DR",
"address_2": "SUITE 201",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376604641",
"telephone_number": "423-857-7650",
"fax_number": "423-857-7655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "PAUL",
"middle_name": "ANDREW",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2017-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TN",
"license": "424",
"primary": true
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110840851",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1511020",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00698768",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8923655",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q003286",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1447279856",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.