Active NPI
Ann Marie Lee, M.D.
- Pediatrics Physician
- Brandon, MS
National Provider Identifier
1801979703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 17117
- Practice address
- 1405 Crossgate Dr W
Brandon, MS 39042-2233 - Phone
- (601) 825-0925
- Fax
- (601) 825-0926
- NPI assigned
- Oct 23, 2006
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 17117 | MS | Primary |
Addresses
Primary practice location
1405 Crossgate Dr W
Brandon, MS 39042-2233
Mailing address
1405 Crossgate Dr W
Brandon, MS 39042-2233
Phone (601) 825-0925
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17117 | MS | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arkansas Pediatric Clinic, PLLC | Pediatrics | Past | Accepting new patients |
| Rankin Children'S Group, PLLC | Pediatrics | Past | Accepting new patients |
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.
-
- Pediatrics Physician
- Brandon, MS
- NPI 1417171794
-
- Pediatrics Physician
- Little Rock, AR
- NPI 1366471195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801979703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 CROSSGATE DR W",
"city": "BRANDON",
"state": "MS",
"postal_code": "390422233",
"telephone_number": "601-825-0925",
"fax_number": "601-825-0926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1405 CROSSGATE DR W",
"city": "BRANDON",
"state": "MS",
"postal_code": "390422233",
"telephone_number": "601-825-0925",
"fax_number": "601-825-0926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ANN",
"middle_name": "MARIE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MS",
"license": "17117",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brandon, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.