Individual provider Active NPI

Cindy F Lee, NP

  • Nurse Practitioner
  • Arlington, GA
National Provider Identifier
1578634382
Registry record updated Sep 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN039505 Issued in GA
Practice address
103 Re Jennings Ave SE
Arlington, GA 39813-8725
Phone
(229) 725-4251
Fax
(229) 725-2212
NPI assigned
Nov 13, 2006
Last updated
Sep 6, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN039505 GA Primary

Addresses

Primary practice location

103 Re Jennings Ave SE
Arlington, GA 39813-8725

Mailing address

24 Willow Glen Dr
Blakely, GA 39823-3700
Phone (229) 723-6274

Other identifiers 1

IdentifierTypeStateIssuer
00803756AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20100805000633 GA Practitioner - Nurse Practitioner 3870626260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany Area Community SVC. BoardGroup PAC ID 9032190483, 19 clinicians

Practice addresses (Care Compare)

601 11TH Ave
Albany, GA 31701-1645
Phone (229) 430-4140

763 Jesse Johnson Dr
Blakely, GA 39823-3224
Phone (229) 430-1842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN039505GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Area Community SVC. Board CurrentSince Feb 19, 2014 Accepting new patients
Albany Area CSB Past Accepting new patients
Calhoun Memorial Hospital Past Accepting new patients

Locations

601 11th Ave
Albany, GA 31701
Phone (229) 352-9368

763 Jesse Johnson Dr
Blakely, GA 39823
Phone (229) 430-4002

Organizations & group practices 3

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315267200000",
    "number": "1578634382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 WILLOW GLEN DR",
            "city": "BLAKELY",
            "state": "GA",
            "postal_code": "398233700",
            "telephone_number": "229-723-6274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 RE JENNINGS AVE SE",
            "city": "ARLINGTON",
            "state": "GA",
            "postal_code": "398138725",
            "telephone_number": "229-725-4251",
            "fax_number": "229-725-2212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CINDY",
        "middle_name": "F",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "RN039505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00803756A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, GA

Sources for this page

Verify at the official NPI Registry.