Individual provider Active NPI

Kenneth Stuart Lee, M. D.

  • Neurological Surgery Physician
  • Greenville, NC
National Provider Identifier
1619079571
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
27482 Issued in NC
Practice address
2325 Stantonsburg Rd
Ecu Physicians Beurosurgical & Spine Center
Greenville, NC 27834-7534
Phone
(252) 752-5156
Fax
(252) 752-0419
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 17725 AZ
Neurological Surgery Physician 207T00000X 27482 NC Primary

Addresses

Primary practice location

2325 Stantonsburg Rd
Ecu Physicians Beurosurgical & Spine Center
Greenville, NC 27834-7534

Mailing address

2325 Stantonsburg Rd
Greenville, NC 27834-7534

Other identifiers 3

IdentifierTypeStateIssuer
51512OtherNCBCBS NC
7951512MedicaidNC
P00709998OtherNCRAILROAD MEDICARE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klee506@direct.vidanthealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20090114000089 NC Practitioner - Neurosurgery 0840353082 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Brody School of Medicine at East Carolina University, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 847-1757

2325 Stantonsburg Rd
Greenville, NC 27834-7534
Phone (919) 731-4048

401 A N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

401 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-0941

417 N Main St
Kenansville, NC 28349-8801
Phone (910) 296-8080

800 WH Smith Blvd
Greenville, NC 27834-3763

850 WH Smith Blvd
Vidant Cardiology Greenville
Greenville, NC 27834-3763
Phone (252) 758-3211

Hospital & facility affiliations

  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040
  • Vidant Chowan Hospital Hospital, Edenton, NC, CCN 341318
  • The Outer Banks Hospital, Inc Hospital, Nags Head, NC, CCN 341324

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
17725AZMDNeurological Surgery Physician
27482NCMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Current Accepting new patients
East Carolina University Neurological Surgery CurrentSince Nov 1, 2008 Accepting new patients
Vidant Medical Group LLC CurrentSince May 1, 2013 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

2325 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 752-5156

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

Interoperability endpoints

  • Direct secure messaging: klee506@direct.vidanthealth.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 4

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1619079571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 STANTONSBURG RD",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 STANTONSBURG RD",
            "address_2": "ECU PHYSICIANS BEUROSURGICAL & SPINE CENTER",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347534",
            "telephone_number": "252-752-5156",
            "fax_number": "252-752-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENNETH",
        "middle_name": "STUART",
        "name_prefix": "Mr.",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "17725",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NC",
            "license": "27482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "51512",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7951512",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00709998",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klee506@direct.vidanthealth.com",
            "affiliation": "N",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.