Individual provider Active NPI

Lee Stanton Clore Jr., M.D.

  • Allergy & Immunology Physician
  • Owensboro, KY
National Provider Identifier
1609873553
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
License
33785 Issued in KY
Practice address
3604 Wathens Crossing
Owensboro, KY 42301-7035
Phone
(270) 684-6144
Fax
(270) 684-2944
NPI assigned
Jul 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology Physician 207K00000X 33785 KY Primary

Addresses

Primary practice location

3604 Wathens Crossing
Owensboro, KY 42301-7035

Mailing address

3604 Wathens Crossing
Owensboro, KY 42301-7035
Phone (270) 684-6144

Other identifiers 3

IdentifierTypeStateIssuer
604818OtherKYWELLCARE OF KENTUCKY, MCO
00541691OtherKYANTHEM MEDICAID
64337850MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20050901000009 KY Practitioner - Allergy/Immunology 4486686284 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Allergy/Immunology
Education
University of Kentucky College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allergy and Asthma Specialists PSCGroup PAC ID 4587737382, 3 clinicians

Practice addresses (Care Compare)

3604 Wathens Xing
Owensboro, KY 42301-7035
Phone (270) 684-6144

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Allergy and Asthma Specialists PSC Allergy & Immunology CurrentSince Jul 1, 2000 Accepting new patients

Locations

3604 Wathens Xing
Owensboro, KY 42301
Phone (270) 684-6144

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.

Hospital & facility affiliations 5

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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638489600000",
    "number": "1609873553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3604 WATHENS CROSSING",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423017035",
            "telephone_number": "270-684-6144",
            "fax_number": "270-684-2944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3604 WATHENS CROSSING",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423017035",
            "telephone_number": "270-684-6144",
            "fax_number": "270-684-2944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLORE",
        "first_name": "LEE",
        "middle_name": "STANTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-07",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "KY",
            "license": "33785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE OF KENTUCKY, MCO",
            "identifier": "604818",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM MEDICAID",
            "identifier": "00541691",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64337850",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owensboro, KY

Sources for this page

Verify at the official NPI Registry.