Organization Active NPI

J. W. Lee, Inc.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Cincinnati, OH
National Provider Identifier
1801290994
Registry record updated Jul 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
J. W. LEE, INC.
Practice address
10500 Montgomery Rd
Cincinnati, OH 45242
Phone
(513) 865-5050
Fax
(813) 865-5050
NPI assigned
Oct 17, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2019

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

Authorized official

Name
Dr. Ji Woo Lee, M.D.NPI 1720192990
Title
President
Phone
(513) 865-5050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X Primary
Medical Specialty Clinic/Center 261QM2500X 35045945 OH

Addresses

Primary practice location

10500 Montgomery Rd
Cincinnati, OH 45242

Mailing address

2935 Thousand Oaks
Suite 294
San Antonio, TX 78247-3312
Phone (210) 494-1100

Other practice location 1

10500 Montgomery Rd
Cincinnati, OH 45242
Phone (513) 865-5050

Other identifiers 2

IdentifierTypeStateIssuer
1720192990OtherNPI
0453790MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141211001264 OH Part B Supplier - Clinic/Group Practice 1254653702 Receives reassigned benefits from 1 practitioner
Practice locations: Cincinnati, OH; Montgomery, OH

National Provider Directory

National Provider Directory

Locations

13467 Wetmore Rd
Ste 294
Wetmore, TX 78247

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563840000000",
    "number": "1801290994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 THOUSAND OAKS",
            "address_2": "SUITE 294",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473312",
            "telephone_number": "210-494-1100",
            "fax_number": "210-494-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 MONTGOMERY RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "45242",
            "telephone_number": "513-865-5050",
            "fax_number": "813-865-5050"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10500 Montgomery Rd",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "45242",
            "country_code": "US",
            "telephone_number": "513-865-5050",
            "fax_number": "813-865-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "J. W. LEE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-17",
        "last_updated": "2019-07-23",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JI",
        "authorized_official_middle_name": "WOO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "513-865-5050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "OH",
            "license": "35045945",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720192990",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0453790",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.