NPIMap

Individual provider Active NPI

Caroline N Lee, PA-C

  • Physician Assistant
  • Atlanta, GA
National Provider Identifier
1548773690
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
11385 Issued in GA
Practice address
691 14TH St NW Ste E
Atlanta, GA 30318-5625
Phone
(404) 816-7900
Fax
(404) 816-7929
NPI assigned
Nov 12, 2017
Last updated
Jan 12, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3451 TN
Physician Assistant 363A00000X 11385 GA Primary

Addresses

Primary practice location

691 14TH St NW Ste E
Atlanta, GA 30318-5625

Mailing address

PO Box 52226
Atlanta, GA 30355-0226

Other practice location 1

100 Springhouse Ct Ste 100
Hendersonville, TN 37075-1610
Phone (615) 824-7491

Other names 1

  • Caroline N Bauknecht Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180418002070 TN Practitioner - Physician Assistant 2264795590 Reassigns benefits to 3 organizations
I20230125003033 GA Practitioner - Physician Assistant 2264795590 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Affiliates LLCGroup PAC ID 5799763975, 14 clinicians

Practice addresses (Care Compare)

3131 Maple Dr NE
Suite 102
Atlanta, GA 30305-2515
Phone (404) 816-7900

4939 Lower Roswell Rd
Suite 104
Marietta, GA 30068-4382
Phone (404) 816-7900

691 14TH St NW
Suite E
Atlanta, GA 30318-5625
Phone (404) 816-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC Physician Assistant CurrentSince Feb 15, 2018 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Feb 15, 2018 Accepting new patients
Tif W Siragusa Past Accepting new patients
Affiliated Dermatologists of Green Hills PC PastSince Sep 1, 2001 Accepting new patients
Advanced Sleep Consultants of Middle TN, Inc Past Accepting new patients
Daec, Inc Past Accepting new patients

Locations

2000 Richard Jones Rd
Ste 220
Nashville, TN 37215
Phone (615) 383-2400

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

Interoperability endpoints

  • Direct secure messaging: caroline.lee@qdp.emadirect.md
  • Direct secure messaging: clee@directaddress.net

Organizations & group practices 9

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

NPI Registry JSON

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

{
    "created_epoch": "1510444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673481600000",
    "number": "1548773690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52226",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303550226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "691 14TH ST NW STE E",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303185625",
            "telephone_number": "404-816-7900",
            "fax_number": "404-816-7929"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Springhouse Ct Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "TN",
            "postal_code": "370751610",
            "country_code": "US",
            "telephone_number": "615-824-7491",
            "fax_number": "615-970-7627",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "CAROLINE",
        "middle_name": "N",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-12",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3451",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "11385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLINE",
            "last_name": "BAUKNECHT",
            "middle_name": "N",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.