Active NPI
Phyllis J Lee, CNP
- Family Nurse Practitioner
- Hattiesburg, MS
National Provider Identifier
1447426192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R867439
- Practice address
- 180 WSF Tatum Dr
Hattiesburg, MS 39401-7700 - Phone
- (601) 450-0805
- Fax
- (601) 450-0806
- NPI assigned
- May 2, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R867439 | MS | Primary |
Addresses
Primary practice location
180 WSF Tatum Dr
Hattiesburg, MS 39401-7700
Mailing address
PO Box 1729
Hattiesburg, MS 39403-1729
Phone (601) 545-8700
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06072709 | Medicaid | MS | |
| P00828627 | Other | MS | RAILROAD MEDICARE |
| 5883830 | Other | MS | CIGNA |
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
- Certified Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1209686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1447426192",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1729",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394031729",
"telephone_number": "601-545-8700",
"fax_number": "601-450-2493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 WSF TATUM DR",
"city": "HATTIESBURG",
"state": "MS",
"postal_code": "394017700",
"telephone_number": "601-450-0805",
"fax_number": "601-450-0806"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "PHYLLIS",
"middle_name": "J",
"name_prefix": "Ms.",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-02",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MS",
"license": "R867439",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "06072709",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00828627",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5883830",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Hattiesburg, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.