Individual provider Active NPI

Angelina Jin Lee

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1760215784
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN290435 Issued in GA
Practice address
1601 Greene St
Columbia, SC 29208-4001
Phone
(803) 777-7412
NPI assigned
Aug 23, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN290435 GA Primary

Addresses

Primary practice location

1601 Greene St
Columbia, SC 29208-4001

Mailing address

1601 Greene St
Columbia, SC 29208-4001
Phone (803) 777-7412

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20251001002968 GA Practitioner - Nurse Practitioner 4385140060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DawoudGroup PAC ID 1951434422, 5 clinicians

Practice addresses (Care Compare)

1630 Pleasant Hill Rd
Suite 340
Duluth, GA 30096-5829
Phone (678) 680-4290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN290435GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dawoud CurrentSince Sep 1, 2025 Accepting new patients

Locations

1630 Pleasant Hill Rd
Ste 340
Duluth, GA 30096
Phone (678) 680-4290

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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": "1724371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1760215784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 GREENE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292084001",
            "telephone_number": "803-777-7412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 GREENE ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292084001",
            "telephone_number": "803-777-7412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANGELINA",
        "middle_name": "JIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-23",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN290435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.