Individual provider Active NPI

Emily Nicole Lee, CRNP

  • Family Nurse Practitioner
  • Eldersburg, MD
National Provider Identifier
1760727655
Registry record updated Mar 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R162073 Issued in MD
Practice address
770 Old Liberty Rd Ste 3
Eldersburg, MD 21784-8500
Phone
(410) 970-8480
Fax
(855) 576-5073
NPI assigned
Dec 3, 2012
Last updated
Mar 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 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 R162073 MD Primary

Addresses

Primary practice location

770 Old Liberty Rd Ste 3
Eldersburg, MD 21784-8500

Mailing address

770 Old Liberty Rd Ste 3
Eldersburg, MD 21784-8500
Phone (410) 970-8480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20130606000222 MD Practitioner - Nurse Practitioner 0042458895 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloom Family Health and WellnessGroup PAC ID 2769824754, 3 clinicians

Practice addresses (Care Compare)

770 Old Liberty Rd
Suite 3
Eldersburg, MD 21784-8500
Phone (667) 367-7545

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R162073MDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians, Inc CurrentSince May 1, 2017 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince May 1, 2017 Accepting new patients
Bloom Family Health & Wellness CurrentSince May 8, 2024 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2435 W Belvedere Ave
Ste 56
Baltimore, MD 21215
Phone (410) 578-8632

6190 Georgetown Blvd
Sykesville, MD 21784
Phone (410) 552-4235

770 Old Liberty Rd
Ste 3
Sykesville, MD 21784
Phone (410) 970-8480

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1354492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742774400000",
    "number": "1760727655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "770 OLD LIBERTY RD STE 3",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217848500",
            "telephone_number": "410-970-8480",
            "fax_number": "855-576-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 OLD LIBERTY RD STE 3",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217848500",
            "telephone_number": "410-970-8480",
            "fax_number": "855-576-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "EMILY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-03",
        "last_updated": "2025-03-24",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R162073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldersburg, MD

Sources for this page

Verify at the official NPI Registry.