Active NPI
Moyuen Mimi Lee, MD
- Surgery Physician
- Little Rock, AR
National Provider Identifier
1720034358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- E2338
- Practice address
- 8315 Cantrell Rd
Plaza 80
Little Rock, AR 72227-2423 - Phone
- (501) 224-0880
- Fax
- (501) 224-1395
- NPI assigned
- May 25, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | E2338 | AR | Primary |
Addresses
Primary practice location
8315 Cantrell Rd
Plaza 80
Little Rock, AR 72227-2423
Mailing address
8315 Cantrell Rd
Plaza 80
Little Rock, AR 72227-2423
Phone (501) 224-0880
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00037405 | Other | AR | RAILROAD MEDICARE |
| 188290000000 | Other | AR | QUALCHOICE |
| 5L347 | Other | AR | ARKANSAS BLUE CROSS AND BLUE SHIELD |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E2338 | AR | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1720034358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8315 CANTRELL RD",
"address_2": "PLAZA 80",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722272423",
"telephone_number": "501-224-0880",
"fax_number": "501-224-1395"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8315 CANTRELL RD",
"address_2": "PLAZA 80",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "722272423",
"telephone_number": "501-224-0880",
"fax_number": "501-224-1395"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MOYUEN",
"middle_name": "MIMI",
"name_prefix": "Prof.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-25",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AR",
"license": "E2338",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00037405",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "QUALCHOICE",
"identifier": "188290000000",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARKANSAS BLUE CROSS AND BLUE SHIELD",
"identifier": "5L347",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.