Individual provider Active NPI

Maria Theresa Lee, FNP-BC

  • Family Nurse Practitioner
  • Woodbridge, VA
National Provider Identifier
1508395245
Registry record updated Aug 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
0024174900 Issued in VA
Practice address
2028B Opitz Blvd # 22191
Woodbridge, VA 22191
Phone
(703) 497-0212
NPI assigned
Jun 7, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Care Registered Nurse 163WP2201X 0001228137 VA
Family Nurse Practitioner 363LF0000X 0024174900 VA Primary

Addresses

Primary practice location

2028B Opitz Blvd # 22191
Woodbridge, VA 22191

Mailing address

2028 Opitz Blvd Ste B
Woodbridge, VA 22191-3326
Phone (703) 497-0212

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
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
0024174900VAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Virginia Pulmonary Associates, P.C. Current Accepting new patients
Virginia Pulmonary Associates, P.C. Current Accepting new patients
Pro Healthcare Servicing, LLC Past Accepting new patients
Pro Healthcare Servicing, LLC PastSince Feb 17, 2020 Accepting new patients

Locations

2028 Opitz Blvd
Ste B
Woodbridge, VA 22191
Phone (703) 490-1112

Organizations & group practices 4

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": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1508395245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 OPITZ BLVD STE B",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221913326",
            "telephone_number": "703-497-0212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028B OPITZ BLVD # 22191",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "22191",
            "telephone_number": "703-497-0212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARIA",
        "middle_name": "THERESA",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "VA",
            "license": "0001228137",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024174900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbridge, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; 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.