Active NPI
Mark S. Lee, MD
- Family Medicine Physician
- Bella Vista, AR
National Provider Identifier
1679515522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- E-5265
- Practice address
- 1 Mercy Way
Bella Vista, AR 72714-3000 - Phone
- (479) 802-5555
- Fax
- (479) 876-2829
- NPI assigned
- Jun 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | E-5265 | AR | Primary |
| Emergency Medicine Physician | 207P00000X | E5265 | AR |
Addresses
Primary practice location
1 Mercy Way
Bella Vista, AR 72714-3000
Mailing address
1 Mercy Way
Bella Vista, AR 72714-3000
Phone (479) 802-5555
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E5265 | AR | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Southeastern Emergency Physicians LLC | Emergency Medicine | Current | Accepting new patients |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| Mercy Health Northwest Arkansas Communities | Current | Accepting new patients | |
| The Covenant Group PA | Emergency Medicine | Past | Accepting new patients |
| Goppert - Trinity Family Care, LLC | Family Medicine | Past | Accepting new patients |
Locations
1 Mercy Way
Bella Vista, AR 72714
Phone (479) 802-5555
3101 SE 14th St
Bentonville, AR 72712
Phone (479) 631-2100
4800 E Johnson Ave
Jonesboro, AR 72405
Phone (870) 732-2100
Interoperability endpoints
- mlee17191@directc.mercy.net
Organizations & group practices 6
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.
-
- Multi-Specialty Clinic/Center
- Rogers, AR
- NPI 1265490916
-
- Multi-Specialty Clinic/Center
- Rogers, AR
- NPI 1326389404
-
- Endocrinology, Diabetes & Metabolism Physician
- Rogers, AR
- NPI 1770087371
-
- Family Medicine Physician
- Kansas City, MO
- NPI 1922097013
-
- Emergency Medicine Physician
- Kansas City, KS
- NPI 1306814389
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1679515522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MERCY WAY",
"city": "BELLA VISTA",
"state": "AR",
"postal_code": "727143000",
"telephone_number": "479-802-5555",
"fax_number": "479-876-2829"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MERCY WAY",
"city": "BELLA VISTA",
"state": "AR",
"postal_code": "727143000",
"telephone_number": "479-802-5555",
"fax_number": "479-876-2829"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MARK",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-12",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "E-5265",
"primary": true
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "AR",
"license": "E5265",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bella Vista, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.