Individual provider Active NPI

Jack Jenchieh Lee

  • Pharmacist
  • Yuma, AZ
National Provider Identifier
1447673751
Registry record updated Jan 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
S015990 Issued in AZ
Practice address
2900 S Pacific Ave
Yuma, AZ 85365-3500
Phone
(928) 341-1288
Fax
(928) 341-0546
NPI assigned
Jan 23, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S015990 AZ Primary

Addresses

Primary practice location

2900 S Pacific Ave
Yuma, AZ 85365-3500

Mailing address

2900 S Pacific Ave
Yuma, AZ 85365-3500
Phone (928) 341-1288

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

State licenses

LicenseStateTypeSpecialty
S015990AZMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1390435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390435200000",
    "number": "1447673751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 S PACIFIC AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853653500",
            "telephone_number": "928-341-1288",
            "fax_number": "928-341-0546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S PACIFIC AVE",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853653500",
            "telephone_number": "928-341-1288",
            "fax_number": "928-341-0546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JACK",
        "middle_name": "JENCHIEH",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-23",
        "last_updated": "2014-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S015990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yuma, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2014; 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.