Active NPI
Charles Lee, M.D
- Anesthesiology Physician
- Palmer, AK
National Provider Identifier
1558313866
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 2913
- Practice address
- 2500 S Woodworth Loop
Palmer, AK 99645-8984 - Phone
- (907) 745-0374
- Fax
- (907) 745-0200
- NPI assigned
- May 16, 2006
- Last updated
- Feb 4, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2913 | AK | Primary |
Addresses
Primary practice location
2500 S Woodworth Loop
Palmer, AK 99645-8984
Mailing address
PO Box 853
Palmer, AK 99645-0853
Phone (907) 745-0374
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MDG417 | Medicaid | AK | |
| 050067817 | Other | AK | LEE RAILROAD MCR# |
| 020257499 | Other | AK | GROUPS ENERGY EMP# |
| MD01001 | Medicaid | AK | |
| 193975000 | Other | AK | GROUPS FED DEPT LABOR# |
| CI9459 | Other | AK | GROUPS RAILROAD MCR# |
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
- Doctor of Medicine
Organizations & group practices 1
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.
-
- Anesthesiology Physician
- Palmer, AK
- NPI 1033160452
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": "1359936000000",
"number": "1558313866",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 853",
"city": "PALMER",
"state": "AK",
"postal_code": "996450853",
"telephone_number": "907-745-0374",
"fax_number": "907-745-0200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 S WOODWORTH LOOP",
"city": "PALMER",
"state": "AK",
"postal_code": "996458984",
"telephone_number": "907-745-0374",
"fax_number": "907-745-0200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "CHARLES",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-16",
"last_updated": "2013-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "AK",
"license": "2913",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MDG417",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LEE RAILROAD MCR#",
"identifier": "050067817",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUPS ENERGY EMP#",
"identifier": "020257499",
"state": "AK"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "MD01001",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUPS FED DEPT LABOR#",
"identifier": "193975000",
"state": "AK"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GROUPS RAILROAD MCR#",
"identifier": "CI9459",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Palmer, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.