NPIMap

Individual provider Active NPI

Clifton C Lee, M.D.

  • Pediatrics Physician
  • Richmond, VA
National Provider Identifier
1457378093
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101053632 Issued in VA
Practice address
1250 E Marshall Street
Pediatrics
Richmond, VA 23298-0510
Phone
(804) 628-7337
Fax
(804) 828-6301
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101053632 VA Primary

Addresses

Primary practice location

1250 E Marshall Street
Pediatrics
Richmond, VA 23298-0510

Mailing address

PO Box 91734
Richmond, VA 23291-1734
Phone (804) 358-6100

Other identifiers 2

IdentifierTypeStateIssuer
006715591MedicaidVA
1457378093MedicaidVA

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
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101053632VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Columbia Healthcare of Central Virginia Inc PastSince Apr 1, 2019 Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Emergency Physicians LLP Past Accepting new patients
Virginia Hospitalists Inc Past Accepting new patients
MCV Associated Physicians Pediatrics PastSince Sep 28, 2021 Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1457378093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 91734",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232911734",
            "telephone_number": "804-358-6100",
            "fax_number": "804-342-7619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL STREET",
            "address_2": "PEDIATRICS",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232980510",
            "telephone_number": "804-628-7337",
            "fax_number": "804-828-6301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CLIFTON",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101053632",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006715591",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1457378093",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; 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.