Elbert C. Lee, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036096877 Issued in IL

Practice address

1005 Health Center Drive
Suite 102
Mattoon, IL 61938

Phone

(217) 258-4042

Fax

(217) 258-4053

NPI assigned

Apr 10, 2006

Last updated

Jun 19, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: elbertlee@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Teladoc Health Medical Group, P.a.

  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Psychiatry

  NPD
• Gibson Community Hospital Association

  dba Gibson Area Hospital and Health Services

  • Critical Access Hospital
  • Gibson City, IL
  • NPI 1114935681
  NPD (past)
• Physician Services Corporation of Southern Illinois Inc.

  dba SSM Health Medical Group

  • Internal Medicine Physician
  • Mount Vernon, IL
  • NPI 1831101807
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529366400000",
    "number": "1740243989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DRIVE",
            "address_2": "SUITE 102",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "61938",
            "telephone_number": "217-258-4042",
            "fax_number": "217-258-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 HEALTH CENTER DRIVE",
            "address_2": "SUITE 102",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "61938",
            "telephone_number": "217-258-4042",
            "fax_number": "217-258-4053"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2311 S Illinois Ave",
            "address_purpose": "LOCATION",
            "city": "Carbondale",
            "state": "IL",
            "postal_code": "629035912",
            "country_code": "US",
            "telephone_number": "618-457-6703",
            "fax_number": "618-549-3734",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ELBERT",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2018-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036096877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096877",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRR MEDICARE NUMBER",
            "identifier": "260045697",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR GROUP NUMBER",
            "identifier": "CH4443",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James A Lathrop, C-PED
• Judy G Latta, M.S.
• Maria Belen Lawless, M.D.
• Valerie Elizabeth Lawrence, M.D.
• Arlene Lee, PHARM D
• Amy J Leifheit, MD
• Alyssa Leman, BS
• Callie Lemon
• Terakeith Lertsburapa, MD
• Howard D Levine, PHD

• Psychiatry Physician in Mattoon, IL
• Providers in Mattoon, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2018; 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.