NPIMap

Individual provider Active NPI

Rusty J Lee, MD

  • Emergency Medicine Physician
  • Concord, NC
National Provider Identifier
1669633277
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
2010-01026 Issued in NC
Practice address
1028 Lee Ann Dr NE Ste 200
Concord, NC 28025
Phone
(704) 782-1892
NPI assigned
Jun 17, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 0116019403 VA
Emergency Medicine Physician 207P00000X 2010-01026 NC Primary

Addresses

Primary practice location

1028 Lee Ann Dr NE Ste 200
Concord, NC 28025

Mailing address

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035
Phone (704) 377-2424

Other practice location 1

501 S Sharon Amity Rd Ste 300
Charlotte, NC 28211-0035
Phone (704) 377-2424

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100729000387 NC Practitioner - Emergency Medicine 9931232865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Brody School of Medicine at East Carolina University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-Atlantic Emergency Medical Associates PLLCGroup PAC ID 4880686823, 100 clinicians

Practice addresses (Care Compare)

10030 Gilead Rd
Huntersville, NC 28078-7545
Phone (704) 316-4040

200 Hawthorne LN
Charlotte, NC 28204-2515
Phone (704) 377-2424

8201 Health Loop
Charlotte, NC 28215-7072
Phone (704) 384-4000

Hospital & facility affiliations

  • Novant Health Huntersville Medical Center Hospital, Huntersville, NC, CCN 340183
  • Novant Health Mint Hill Medical Center Hospital, Charlotte, NC, CCN 340190
  • Novant Health Presbyterian Medical Center Hospital, Charlotte, NC, CCN 340053

Merit-based Incentive Payment System (MIPS)

Final score
84.97 of 100Reported as group
Quality
79.68
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0116019403VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Atlantic Emergency Medical Associates, PLLC Emergency Medicine CurrentSince Sep 1, 2018 Accepting new patients
Mema SC LLC Emergency Medicine PastSince Oct 13, 2024 Accepting new patients
Fox Mountain Emergency Physicians Emergency Medicine Past Accepting new patients
North Carolina Em-I Medical Services PC Past Accepting new patients
North Carolina Emergency Partners LLC Emergency Medicine Past Accepting new patients

Locations

200 Hawthorne Ln
Charlotte, NC 28204
Phone (704) 377-2424

501 S Sharon Amity Rd
Ste 300
Charlotte, NC 28211
Phone (704) 319-5821

171 Fairview Rd
Mooresville, NC 28117
Phone (704) 660-4000

218 Old Mocksville Rd
Statesville, NC 28625
Phone (704) 838-7461

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

Organizations & group practices 5

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 6

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": "1213660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1669633277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 S SHARON AMITY RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282110035",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1028 LEE ANN DR NE STE 200",
            "city": "CONCORD",
            "state": "NC",
            "postal_code": "28025",
            "telephone_number": "704-782-1892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "501 S Sharon Amity Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282110035",
            "country_code": "US",
            "telephone_number": "704-377-2424",
            "fax_number": "704-377-2687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "RUSTY",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-17",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116019403",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2010-01026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, NC

Sources for this page

Verify at the official NPI Registry.