Individual provider Active NPI

Mark Keith Lee, MD

  • Internal Medicine Physician
  • Crossville, TN
National Provider Identifier
1528079969
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD17713 Issued in TN
Practice address
100 Lantana Road
Suite 202
Crossville, TN 38555-1903
Phone
(931) 484-5141
Fax
(931) 484-5620
NPI assigned
Aug 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD17713 TN Primary

Addresses

Primary practice location

100 Lantana Road
Suite 202
Crossville, TN 38555-1903

Mailing address

100 Lantana Road
Suite 202
Crossville, TN 38555-1903
Phone (931) 484-5141

Other identifiers 2

IdentifierTypeStateIssuer
139003OtherTNBLUE CROSS
3067149MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lee.mark@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050818001105 TN Practitioner - Internal Medicine 1759311749 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Mississippi School of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

100 Lantana Rd
Suite 202
Crossville, TN 38555-1903
Phone (931) 484-5141

111 Clyde St
Loudon, TN 37774-1600
Phone (865) 458-1554

132 Stonehenge Dr
Crossville, TN 38558-6279
Phone (931) 484-5141

6600 Nightingale LN
Knoxville, TN 37909-2754
Phone (865) 632-5885

Hospital & facility affiliations

  • Gentiva Hospice, Nashville, TN, CCN 441545
  • Cumberland Medical Center Hospital, Crossville, TN, CCN 440009

Merit-based Incentive Payment System (MIPS)

Final score
94.04 of 100Reported as individual
Quality
89.16
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy290
Upper gastrointestinal (GI) endoscopy for acid reflux134

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD17713TNMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. Internal Medicine CurrentSince Jul 1, 2012 Accepting new patients
Covenant Medical Group, Inc CurrentSince Jul 1, 2012 Accepting new patients
Hospital Medicine Services of Tennessee PC Internal Medicine CurrentSince Jan 1, 2016 Accepting new patients
Southeastern Physician Services PC Internal Medicine CurrentSince Sep 1, 2012 Accepting new patients
Crossville Medical Group PA Past Accepting new patients

Locations

2305 Chambliss Ave NW
Cleveland, TN 37311
Phone (423) 559-6000

421 S Main St
Crossville, TN 38555
Phone (931) 260-1465

100 Lantana Rd
Ste 202
Crossville, TN 38555
Phone (931) 484-5141

4965 Peavine Rd
Crossville, TN 38571
Phone (931) 484-5141

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

742 Middle Creek Rd
Sevierville, TN 37862
Phone (865) 429-6100

1201 Bishop St
Union City, TN 38261
Phone (423) 698-6061

Interoperability endpoints

  • Direct secure messaging: lee.mark@covenanthealth.cernerdirect.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1528079969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LANTANA ROAD",
            "address_2": "SUITE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385551903",
            "telephone_number": "931-484-5141",
            "fax_number": "931-484-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LANTANA ROAD",
            "address_2": "SUITE 202",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385551903",
            "telephone_number": "931-484-5141",
            "fax_number": "931-484-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "MARK",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TN",
            "license": "MD17713",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "139003",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3067149",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lee.mark@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "100 Lantana Road",
            "address_2": "Suite 202",
            "city": "Crossville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "385551903",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

Verify at the official NPI Registry.