Active NPI
Michelle Sohn Lee
- Family Nurse Practitioner
- San Francisco, CA
National Provider Identifier
1679925598
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 20302
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20302 | SC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Carolina Cape Fear Medical Group, PA | Current | Accepting new patients | |
| Healthsouth Men'S Clinic | Past | Accepting new patients |
Locations
3637 Cape Center Dr
Fayetteville, NC 28304
Phone (910) 483-4938
Interoperability endpoints
- 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.
-
- Cardiovascular Disease Physician
- Fayetteville, NC
- NPI 1124450572
-
- Specialist
- Fayetteville, NC
- NPI 1851508949
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2024; 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.