Individual provider Active NPI

Christine I Lee, D.O.

  • Nephrology Physician
  • Wooster, OH
National Provider Identifier
1598870446
Registry record updated Jun 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
34-6084 Issued in OH
Practice address
1761 Beall Ave
Suite 3C
Wooster, OH 44691-2342
Phone
(330) 345-5374
Fax
(330) 345-5814
NPI assigned
Aug 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 34-6084 OH Primary

Addresses

Primary practice location

1761 Beall Ave
Suite 3C
Wooster, OH 44691-2342

Mailing address

1761 Beall Ave
Suite 3C
Wooster, OH 44691-2342
Phone (330) 345-5374

Other identifiers 1

IdentifierTypeStateIssuer
2119237MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20111220000710 OH Practitioner - NephrologyPractitioner - Internal Medicine 6608042742 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
NephrologyAlso: Internal Medicine
Education
Ohio University, College of Osteopathic Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1761 Beall Ave
Suite 3C
Wooster, OH 44691-2342
Phone (330) 345-5374

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
34-6084OHMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Community Nephrology Services, Inc. Nephrology CurrentSince Feb 13, 2014 Accepting new patients
Inpatient Medical Services, Inc. CurrentSince Dec 1, 2014 Accepting new patients
Adult Geriatrics of Wooster, Inc. PastSince Apr 1, 2014 Accepting new patients

Locations

155 5th St NE
Barberton, OH 44203
Phone (330) 615-3000

6847 N Chestnut St
Ravenna, OH 44266
Phone (330) 296-9606

1761 Beall Ave
Ste 3C
Wooster, OH 44691
Phone (330) 345-5374

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9168/brand/1/csg/1/fhir/r4
  • Direct secure messaging: christine.lee.1@9168.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1598870446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE",
            "address_2": "SUITE 3C",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-345-5374",
            "fax_number": "330-345-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1761 BEALL AVE",
            "address_2": "SUITE 3C",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446912342",
            "telephone_number": "330-345-5374",
            "fax_number": "330-345-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHRISTINE",
        "middle_name": "I",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-20",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "OH",
            "license": "34-6084",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2119237",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.