Individual provider Active NPI

Lee E Speed, PA

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1558313106
Registry record updated Aug 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1704 Issued in TN
Practice address
9125 Cross Park Dr Ste 200
Knoxville, TN 37923-4563
Phone
(865) 632-5900
Fax
(865) 374-2129
NPI assigned
May 16, 2006
Last updated
Aug 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1704 TN Primary

Addresses

Primary practice location

9125 Cross Park Dr Ste 200
Knoxville, TN 37923-4563

Mailing address

PO Box 1754
Allentown, PA 18105-1754
Phone (610) 798-4500

Other identifiers 5

IdentifierTypeStateIssuer
500443524OtherPACAPITAL BLUE CROSS
P00186451OtherPARAILROAD MEDICARE
3665361MedicaidTN
0993510OtherPAKEYSTONE CENTRAL
20045751OtherPAAMERIHEALTH MERCY

Electronic endpoints 1

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, IA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090406000302 TN Practitioner - Physician Assistant 5496711764 Reassigns benefits to 1 organization
I20230913003928 IA Practitioner - Physician Assistant 5496711764 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Iowa Mercy ClinicsGroup PAC ID 7810809076, 304 clinicians

Practice addresses (Care Compare)

1000 4TH St SW
Mason City, IA 50401-2800

635 E US Hwy 9
Mercyone Forest City Family Medicine
Forest City, IA 50436-1028
Phone (641) 585-2904

Merit-based Incentive Payment System (MIPS)

Final score
81.55 of 100Reported as group
Quality
73.89
Promoting interoperability
93
Improvement activities
40
Cost
70.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Iowa Mercy Clinics Physician Assistant CurrentSince Aug 27, 2023 Accepting new patients
North Iowa Mercy Clinics Current Accepting new patients
North Iowa Mercy Clinics CurrentSince Aug 27, 2023 Accepting new patients
Lehigh Valley Cardio Diagnostics PC Past Accepting new patients

Locations

250 S Crescent Dr
Mason City, IA 50401
Phone (541) 422-6588

Organizations & group practices 6

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1558313106",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1754",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181051754",
            "telephone_number": "610-798-4500",
            "fax_number": "610-798-4699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9125 CROSS PARK DR STE 200",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234563",
            "telephone_number": "865-632-5900",
            "fax_number": "865-374-2129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEED",
        "first_name": "LEE",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "1704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "500443524",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00186451",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3665361",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE CENTRAL",
            "identifier": "0993510",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIHEALTH MERCY",
            "identifier": "20045751",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "speed.lee@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9125 Cross Park Dr Ste 200",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234563",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.