NPIMap

Individual provider Active NPI

Insook Lee, M.D.

  • Internal Medicine Physician
  • Glen Allen, VA
National Provider Identifier
1720170855
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101045418 Issued in VA
Practice address
4050 Innslake Dr
Suite 308
Glen Allen, VA 23060-3327
Phone
(804) 521-5315
Fax
(804) 521-5312
NPI assigned
Sep 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0101045418 VA Primary

Addresses

Primary practice location

4050 Innslake Dr
Suite 308
Glen Allen, VA 23060-3327

Mailing address

4050 Innslake Dr
Suite 308
Glen Allen, VA 23060-3327
Phone (804) 521-5315

Other identifiers 4

IdentifierTypeStateIssuer
302011OtherANTHEM
58-83504MedicaidVA
1451464OtherCIGNA
1720170855MedicaidVA

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

LicenseStateTypeSpecialty
0101045418VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Immaculate Hospital LLC Past Accepting new patients
Culpeper Medical Associates, LLC Past Accepting new patients

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1720170855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4050 INNSLAKE DR",
            "address_2": "SUITE 308",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603327",
            "telephone_number": "804-521-5315",
            "fax_number": "804-521-5312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4050 INNSLAKE DR",
            "address_2": "SUITE 308",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230603327",
            "telephone_number": "804-521-5315",
            "fax_number": "804-521-5312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "INSOOK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101045418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "302011",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "58-83504",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1451464",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1720170855",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Allen, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; 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.