Active NPI
Soo Jin Lee
- Medical-Surgical Registered Nurse
- Wichita, KS
National Provider Identifier
1699669176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical-Surgical Registered Nurse
- License
- 15165710102
- Practice address
- 15630 E 21St CT N
Wichita, KS 67228-7400 - Phone
- (316) 794-6133
- Fax
- (316) 794-6133
- NPI assigned
- Jun 7, 2025
- 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 |
|---|---|---|---|---|
| Medical-Surgical Registered Nurse | 163WM0705X | 15165710102 | KS | Primary |
Addresses
Primary practice location
15630 E 21St CT N
Wichita, KS 67228-7400
Mailing address
600 Medical Center Dr
Newton, KS 67114-8780
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
| License | State | Type | Specialty |
|---|---|---|---|
| 15165710102 | KS | MD | Medical-Surgical Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1749254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749254400000",
"number": "1699669176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "600 MEDICAL CENTER DR",
"city": "NEWTON",
"state": "KS",
"postal_code": "671148780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15630 E 21ST CT N",
"city": "WICHITA",
"state": "KS",
"postal_code": "672287400",
"telephone_number": "316-794-6133",
"fax_number": "316-794-6133"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "SOO JIN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-06-07",
"last_updated": "2025-06-07",
"certification_date": "2025-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "163WM0705X",
"taxonomy_group": "",
"desc": "Registered Nurse, Medical-Surgical",
"state": "KS",
"license": "15165710102",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wichita, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.