Active NPI
Jessica Lee
- Nurse's Aide
- North East, MD
National Provider Identifier
1477960532
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse's Aide
- License
- A00101865
- Practice address
- 16 Mahogany Dr
North East, MD 21901-3616 - Phone
- (443) 907-6568
- NPI assigned
- Jul 21, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | A00101865 | MD | Primary |
Addresses
Primary practice location
16 Mahogany Dr
North East, MD 21901-3616
Mailing address
16 Mahogany Drive
North East, MD 21901
Phone (443) 907-6568
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
| License | State | Type | Specialty |
|---|---|---|---|
| A00101865 | MD | MD | Nurse's Aide |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1405900800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405900800000",
"number": "1477960532",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 MAHOGANY DRIVE",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "21901",
"telephone_number": "443-907-6568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 MAHOGANY DR",
"city": "NORTH EAST",
"state": "MD",
"postal_code": "219013616",
"telephone_number": "443-907-6568"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JESSICA",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-21",
"last_updated": "2014-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "376K00000X",
"taxonomy_group": "",
"desc": "Nurse's Aide",
"state": "MD",
"license": "A00101865",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North East, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.