Individual provider Active NPI

Jae Jeong Gloria Lee, DAOM

  • Acupuncturist
  • Cumberland, RI
National Provider Identifier
1689288649
Registry record updated Jul 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
AcupuncturistTaxonomy code 171100000X
License
DA00468 Issued in RI
Practice address
175 Nate Whipple Hwy Ste 205
Cumberland, RI 02864-1425
Phone
(401) 371-8779
Fax
(401) 543-2723
NPI assigned
Sep 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X DA00468 RI Primary
Nutritionist 133N00000X

Addresses

Primary practice location

175 Nate Whipple Hwy Ste 205
Cumberland, RI 02864-1425

Mailing address

175 Nate Whipple Hwy Ste 205
Cumberland, RI 02864-1425
Phone (401) 371-8779

Other names 1

  • Dr. Jae Jeong Gloria Lee Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DA00468RIMDAcupuncturist

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Ki Acupuncture, Inc Acupuncturist CurrentSince Sep 13, 2020 Accepting new patients
Acupuncture Specialists & Wellness Center, LLC Acupuncturist CurrentSince Sep 17, 2023 Accepting new patients

Locations

175 Nate Whipple Hwy
Ste 205
Cumberland, RI 02864
Phone (401) 658-1561

136 W Main Rd
#A
Middletown, RI 02842
Phone (401) 573-7063

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": "1599436800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784073600000",
    "number": "1689288649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 NATE WHIPPLE HWY STE 205",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028641425",
            "telephone_number": "401-371-8779",
            "fax_number": "401-543-2723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 NATE WHIPPLE HWY STE 205",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028641425",
            "telephone_number": "401-371-8779",
            "fax_number": "401-543-2723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JAE JEONG",
        "middle_name": "GLORIA",
        "credential": "DAOM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-07",
        "last_updated": "2026-07-15",
        "certification_date": "2026-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "RI",
            "license": "DA00468",
            "primary": true
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAE JEONG",
            "last_name": "LEE",
            "middle_name": "GLORIA",
            "prefix": "DR.",
            "credential": "DA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cumberland, RI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.