Individual provider Active NPI

Por Lee, RN

  • Registered Nurse
  • Milwaukee, WI
National Provider Identifier
1609219963
Registry record updated Apr 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
195185-30 Issued in WI
Practice address
5837 N 72ND St
Milwaukee, WI 53218-1823
Phone
(414) 628-0089
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 195185-30 WI Primary

Addresses

Primary practice location

5837 N 72ND St
Milwaukee, WI 53218-1823

Mailing address

5837 N 72ND St
Milwaukee, WI 53218-1823
Phone (414) 628-0089

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
195185-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Great Horizon Transportation LLC Current Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1609219963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5837 N 72ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532181823",
            "telephone_number": "414-628-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5837 N 72ND ST",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532181823",
            "telephone_number": "414-628-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "POR",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "195185-30",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.

Verify at the official NPI Registry.