Active NPI
Juanita Perry Lee, ITFSBA
- Specialist
- Goldsboro, NC
National Provider Identifier
1598894545
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Practice address
- 220 N Marion Dr
Goldsboro, NC 27534-7613 - Phone
- (919) 738-6749
- Fax
- (919) 751-3930
- NPI assigned
- Mar 5, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Specialist | 174400000X | Primary |
Addresses
Primary practice location
220 N Marion Dr
Goldsboro, NC 27534-7613
Mailing address
220 N Marion Dr
Goldsboro, NC 27534-7613
Phone (919) 738-6749
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8300634K | Medicaid | NC | |
| 8300634 | Medicaid | NC |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1598894545",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "220 N MARION DR",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275347613",
"telephone_number": "919-738-6749",
"fax_number": "919-751-3930"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "220 N MARION DR",
"city": "GOLDSBORO",
"state": "NC",
"postal_code": "275347613",
"telephone_number": "919-738-6749",
"fax_number": "919-751-3930"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JUANITA",
"middle_name": "PERRY",
"name_prefix": "Mrs.",
"credential": "ITFSBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8300634K",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8300634",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Goldsboro, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.