Active NPI
Jonathan Gene Lee, FNP-BC
- Family Nurse Practitioner
- Rancho Cucamonga, CA
National Provider Identifier
1770090128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- NP95007695
- Practice address
- 8692 9TH St Unit 24
Rancho Cucamonga, CA 91730-0809 - Phone
- (909) 518-9673
- NPI assigned
- Jan 8, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | NP95007695 | CA | Primary |
Addresses
Primary practice location
8692 9TH St Unit 24
Rancho Cucamonga, CA 91730-0809
Mailing address
8692 9TH St Unit 24
Rancho Cucamonga, CA 91730-0809
Phone (909) 518-9673
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2017030612 | Other | ANCC BOARD CERTIFICATION | |
| 661019 | Other | CA | CALIFORNIA BOARD OF REGISTERED NURSING |
| NPF95007695 | Other | CA | CALIFORNIA BOARD OF REGISTERED NURSING - FURNISHING NUMBER |
| NP95007695 | Other | CA | CALIFORNIA BOARD OF REGISTERED NURSING - NURSE PRACTITIONER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NP95007695 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515369600000",
"number": "1770090128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8692 9TH ST UNIT 24",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300809",
"telephone_number": "909-518-9673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8692 9TH ST UNIT 24",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917300809",
"telephone_number": "909-518-9673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JONATHAN",
"middle_name": "GENE",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-08",
"last_updated": "2018-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "NP95007695",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANCC BOARD CERTIFICATION",
"identifier": "2017030612",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF REGISTERED NURSING",
"identifier": "661019",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF REGISTERED NURSING - FURNISHING NUMBER",
"identifier": "NPF95007695",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF REGISTERED NURSING - NURSE PRACTITIONER",
"identifier": "NP95007695",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.