Individual provider Active NPI

Michelle Sohn Lee

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1679925598
Registry record updated Jun 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20302 Issued in SC
Practice address
2443 Fillmore St # 38015799
San Francisco, CA 94115-1814
Phone
(650) 865-5177
Fax
(650) 352-5226
NPI assigned
Jul 2, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20302 SC Primary

Addresses

Primary practice location

2443 Fillmore St # 38015799
San Francisco, CA 94115-1814

Mailing address

5920 100TH St SW
Ste 26
Lakewood, WA 98499-2751
Phone (210) 723-1885

Other practice location 1

5920 100th St SW Ste 26
Lakewood, WA 98499-2751
Phone (253) 588-0756

Other practice location 2

1205 N Walnut St
Bloomington, IN 47404-3565
Phone (812) 320-2284

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20160926001656 SC Practitioner - Nurse Practitioner 6800183401
I20191120000715 NC Practitioner - Nurse Practitioner 6800183401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20302SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Cape Fear Medical Group, PA CurrentSince Oct 22, 2019 Accepting new patients
Healthsouth Men'S Clinic PastSince Oct 22, 2019 Accepting new patients

Locations

3637 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 483-4938

Interoperability endpoints

  • Direct secure messaging: michelle.lee.1@30093.direct.athenahealth.com

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1467417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718064000000",
    "number": "1679925598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 100TH ST SW",
            "address_2": "STE 26",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992751",
            "telephone_number": "210-723-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2443 FILLMORE ST # 38015799",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941151814",
            "telephone_number": "650-865-5177",
            "fax_number": "650-352-5226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5920 100th St SW Ste 26",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984992751",
            "country_code": "US",
            "telephone_number": "253-588-0756",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1205 N Walnut St",
            "address_purpose": "LOCATION",
            "city": "Bloomington",
            "state": "IN",
            "postal_code": "474043565",
            "country_code": "US",
            "telephone_number": "812-320-2284",
            "fax_number": "812-957-0011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "MICHELLE",
        "middle_name": "SOHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-02",
        "last_updated": "2024-06-11",
        "certification_date": "2024-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.