Kangweon Lee, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN2340947 Issued in MA

Practice address

19 Dodge St
Beverly, MA 01915-1705

Phone

(857) 344-0545

NPI assigned

Mar 3, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• CVS Clinic Primary Care PLLC

  • Multi-Specialty Clinic/Center
  • Swampscott, MA
  • NPI 1366206955
  Medicare reassignment NPD
• Molina Care Connections, LLC.

  dba Molina CC

  • Nurse Practitioner
  • Long Beach, CA
  • NPI 1407243223

  MA

  Medicare reassignment NPD
• CVS Clinic Primary Care PLLC

  • Multi-Specialty Clinic/Center
  • Beverly, MA
  • NPI 1629832225
  NPD
• CVS Clinic Primary Care PLLC

  • Multi-Specialty Clinic/Center
  • Charlestown, MA
  • NPI 1760230064
  NPD
• Ipc Hospitalists of New England, P.C.

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1659555266

  Nurse Practitioner

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755993600000",
    "number": "1720673544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 DODGE ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151705",
            "telephone_number": "857-344-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KANGWEON",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-03",
        "last_updated": "2025-08-24",
        "certification_date": "2025-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "RN2340947",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2340947",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2340947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ledgewood Healthcare Corporation (Ledgewood Rehabilitation and Skilled Nursing Center)
• Ledgewood SNF LLC (Ledgewood Rehabilitation and Skilled Nursing Center)
• Danielle M Ledoux, M.D.
• Nicole E Lee Rocha
• Jennifer Wanda Lee, M.D.
• Meng-Chieh Lee, DDS
• Morgan Lee
• Savannah Victoria Lee, M.S., OTR/L
• Marc P Lefebvre, M.D.
• Gina Lefkowitz, DNP, FNP-BC

• Family Nurse Practitioner in Beverly, MA
• Providers in Beverly, MA by specialty
• Family Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2025; 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.

Verify at the official NPI Registry.