Individual provider Active NPI

Kristen Colleen Lee, FNP

  • Family Nurse Practitioner
  • Mather, CA
National Provider Identifier
1760249429
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95029143 Issued in CA
Practice address
10535 Hospital Way BLDG 650
Mather, CA 95655-4200
Phone
(916) 843-7000
NPI assigned
Feb 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 95029143 CA
Primary Care Nurse Practitioner 363LP2300X 95029143 CA
Family Nurse Practitioner 363LF0000X 95029143 CA Primary

Addresses

Primary practice location

10535 Hospital Way BLDG 650
Mather, CA 95655-4200

Mailing address

9974 Ocean Dunes CT
Sacramento, CA 95829-8009
Phone (916) 662-3422

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20250917002757 CA Practitioner - Nurse Practitioner 4880198407 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elk Grove Urgent Care IncGroup PAC ID 0648340976, 15 clinicians

Practice addresses (Care Compare)

9045 Bruceville Rd
Suite 100
Elk Grove, CA 95758-5950
Phone (916) 479-9110

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95029143CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elk Grove Urgent Care Inc CurrentSince Sep 1, 2025 Accepting new patients

Locations

9045 Bruceville Rd
Ste 100
Elk Grove, CA 95758
Phone (916) 479-9110

Organizations & group practices 2

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716940800000",
    "number": "1760249429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9974 OCEAN DUNES CT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958298009",
            "telephone_number": "916-662-3422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10535 HOSPITAL WAY BLDG 650",
            "city": "MATHER",
            "state": "CA",
            "postal_code": "956554200",
            "telephone_number": "916-843-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KRISTEN",
        "middle_name": "COLLEEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95029143",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "95029143",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95029143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mather, CA

Sources for this page

Verify at the official NPI Registry.