Individual provider Active NPI

Emily Lee, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Evans, GA
National Provider Identifier
1750856712
Registry record updated Nov 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9005 Issued in GA
Practice address
4720 Washington Rd
Evans, GA 30809
Phone
(706) 774-7263
Fax
(706) 774-7230
NPI assigned
Oct 5, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 28, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X 9005 GA Primary

Addresses

Primary practice location

4720 Washington Rd
Evans, GA 30809

Mailing address

PO Box 1705
Augusta, GA 30903-1705
Phone (706) 774-7263

Other practice location 1

447 N Belair Rd Ste 101
Evans, GA 30809-3091
Phone (803) 646-1476

Other practice location 2

447 N Belair Rd Ste 101
Evans, GA 30809-3091
Phone (803) 646-1476

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, GA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181212000029 SC Practitioner - Physician Assistant 8325382765 Reassigns benefits to 1 organization
I20190103003270 GA Practitioner - Physician Assistant 8325382765 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Piedmont Professional Services LLCGroup PAC ID 8921176231, 171 clinicians

Practice addresses (Care Compare)

1021 Silver Bluff Rd
Aiken, SC 29803-5879
Phone (803) 648-0587

107 Walnut LN
Suite 102
North Augusta, SC 29860-8629
Phone (803) 202-7110

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
3103SCMDGeneral Practice Dentistry
9005GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Group LLC Single Specialty Current Accepting new patients
University Health Care Physicians LLC Single Specialty Current Accepting new patients
University Prompt Care Single Specialty Current Accepting new patients
Piedmont Medical Care Corporation Single Specialty Past Accepting new patients

Locations

447 N Belair Rd
Ste 101
Evans, GA 30809
Phone (706) 854-2222

4720 Washington Rd
Evans, GA 30809
Phone (706) 650-0111

Organizations & group practices 5

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543363200000",
    "number": "1750856712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1705",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309031705",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4720 WASHINGTON RD",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "30809",
            "telephone_number": "706-774-7263",
            "fax_number": "706-774-7230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "447 N Belair Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093091",
            "country_code": "US",
            "telephone_number": "803-646-1476",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "447 N Belair Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Evans",
            "state": "GA",
            "postal_code": "308093091",
            "country_code": "US",
            "telephone_number": "803-646-1476",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "EMILY",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "9005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evans, GA

Sources for this page

Verify at the official NPI Registry.