Individual provider Active NPI

Brandy Zell Lee, APRN

  • Family Nurse Practitioner
  • Portsmouth, VA
National Provider Identifier
1497220511
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024184579 Issued in VA
Practice address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone
(757) 953-5000
NPI assigned
Oct 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 0024184579 VA Primary
Family Nurse Practitioner 363LF0000X AP138965 TX

Addresses

Primary practice location

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Mailing address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Other practice location 1

494 Springhill St Ste 100
Jasper, TX 75951-5055
Phone (409) 224-3587

Other names 1

  • Brandy Zell McKibbin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024184579VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CMH Physician Services, LLC CurrentSince May 16, 2023 Accepting new patients
CMH Physician Services, LLC CurrentSince May 16, 2023 Accepting new patients
Port Arthur Emergency Physicians CurrentSince Jun 3, 2019 Accepting new patients

Locations

2555 Jimmy Johnson Blvd
Port Arthur, TX 77640
Phone (409) 724-7389

1755 N Mecklenburg Ave
South Hill, VA 23970
Phone (434) 584-2273

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1497220511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "757-953-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "494 Springhill St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Jasper",
            "state": "TX",
            "postal_code": "759515055",
            "country_code": "US",
            "telephone_number": "409-224-3587",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "BRANDY",
        "middle_name": "ZELL",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-04",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024184579",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP138965",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "MCKIBBIN",
            "middle_name": "ZELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portsmouth, VA

Sources for this page

Verify at the official NPI Registry.