Individual provider Active NPI

Yoomi Lee

  • Gerontology Nurse Practitioner
  • Colebrook, NH
National Provider Identifier
1497205884
Registry record updated Aug 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
064054-23 Issued in NH
Practice address
141 Corliss LN
Colebrook, NH 03576-3206
Phone
(603) 237-8336
Fax
(603) 237-4467
NPI assigned
Oct 10, 2016
Last updated
Aug 14, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 064054-23 NH Primary
Registered Nurse 163W00000X 72982 NE

Addresses

Primary practice location

141 Corliss LN
Colebrook, NH 03576-3206

Mailing address

141 Corliss Lane
Colebrook, NH 03576-3206
Phone (603) 237-8336

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201212000102 NH Order and Referring Only - Nurse Practitioner 0648556696

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
72982NEMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502668800000",
    "number": "1497205884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 CORLISS LANE",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "035763206",
            "telephone_number": "603-237-8336",
            "fax_number": "603-237-4467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 CORLISS LN",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "035763206",
            "telephone_number": "603-237-8336",
            "fax_number": "603-237-4467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "YOOMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2017-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NH",
            "license": "064054-23",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NE",
            "license": "72982",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colebrook, NH

Sources for this page

Verify at the official NPI Registry.