Individual provider Active NPI

Younchan Lee, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Provo, UT
National Provider Identifier
1609223726
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
8636132-4405 Issued in UT
Practice address
750 N Freedom Blvd
Provo, UT 84601
Phone
(801) 471-5260
NPI assigned
May 18, 2016
Last updated
Aug 20, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 8636132-4405 UT Primary

Addresses

Primary practice location

750 N Freedom Blvd
Provo, UT 84601

Mailing address

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 471-5260

Other practice location 1

316 south 150 west
orem, UT 84058
Phone (801) 471-5260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20181002000176 UT Practitioner - Nurse Practitioner 0446501407 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8636132-4405UTMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wasatch Behavioral Health Special Service District CurrentSince Aug 15, 2018 Accepting new patients
Wasatch Behavioral Health Special Service District CurrentSince Aug 15, 2018 Accepting new patients

Locations

55 S 5th E
Heber City, UT 84032
Phone (435) 654-2700

750 N Freedom Blvd
Provo, UT 84601
Phone (801) 373-0639

750 N Freedom Blvd
Ste 300
Provo, UT 84601
Phone (801) 372-4760

Organizations & group practices 2

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": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1609223726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846011677",
            "telephone_number": "801-471-5260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 N FREEDOM BLVD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84601",
            "telephone_number": "801-471-5260"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "316 south 150 west",
            "address_purpose": "LOCATION",
            "city": "orem",
            "state": "UT",
            "postal_code": "84058",
            "country_code": "US",
            "telephone_number": "801-471-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "YOUNCHAN",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-18",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "UT",
            "license": "8636132-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

Verify at the official NPI Registry.