Individual provider Active NPI

Soo Paik Lee, MD

  • Family Medicine Physician
  • Memphis, TN
National Provider Identifier
1770716524
Registry record updated May 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD0000048922 Issued in TN
Practice address
5475 Poplar Ave
Suite #106
Memphis, TN 38119-3730
Phone
(901) 254-8040
NPI assigned
Aug 27, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD0000048922 TN Primary

Addresses

Primary practice location

5475 Poplar Ave
Suite #106
Memphis, TN 38119-3730

Mailing address

5475 Poplar Ave
Suite #106
Memphis, TN 38119-3730
Phone (901) 254-8040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171114002729 TN Practitioner - Family Practice 7810043288 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harper Medical Group, PCGroup PAC ID 5799961850, 13 clinicians

Practice addresses (Care Compare)

5475 Poplar Ave
Suite 106
Memphis, TN 38119-3730
Phone (901) 254-8040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD0000048922TNMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harper Medical Group, PC CurrentSince Aug 26, 2017 Accepting new patients

Locations

5475 Poplar Ave
Ste 106
Memphis, TN 38119
Phone (901) 254-8040

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": "1251331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369267200000",
    "number": "1770716524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5475 POPLAR AVE",
            "address_2": "SUITE #106",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193730",
            "telephone_number": "901-254-8040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5475 POPLAR AVE",
            "address_2": "SUITE #106",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381193730",
            "telephone_number": "901-254-8040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "SOO",
        "middle_name": "PAIK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-27",
        "last_updated": "2013-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD0000048922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.