Individual provider Active NPI

Nicole Lee

  • Family Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1730595943
Registry record updated Aug 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2291507 Issued in MA
Practice address
10 Bay Cliff Cir
Plymouth, MA 02360-1458
Phone
(617) 291-3702
NPI assigned
Jul 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 671865-1 NY
Family Nurse Practitioner 363LF0000X RN2291507 MA Primary

Addresses

Primary practice location

10 Bay Cliff Cir
Plymouth, MA 02360-1458

Mailing address

10 Bay Cliff Cir
Plymouth, MA 02360-1458

Other practice location 1

617 W 168th St
Apt 2A
New York, NY 10032-3703
Phone (617) 291-3702

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
RN2291507MAMDFamily Nurse Practitioner
671865-1NYMDStudent in an Organized Health Care Education/Training Program

NPI Registry JSON

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

{
    "created_epoch": "1404777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597449600000",
    "number": "1730595943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 BAY CLIFF CIR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023601458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 BAY CLIFF CIR",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023601458",
            "telephone_number": "617-291-3702"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 W 168th St",
            "address_2": "Apt 2A",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100323703",
            "country_code": "US",
            "telephone_number": "617-291-3702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-08",
        "last_updated": "2020-08-15",
        "certification_date": "2020-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NY",
            "license": "671865-1",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2291507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2020; 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.