NPIMap

Individual provider Active NPI

Jessica Nicole Lee, DO

  • Internal Medicine Physician
  • Lee's Summit, MO
National Provider Identifier
1811284607
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2014014081 Issued in MO
Practice address
3808 SW Sandstone Dr
Lees Summit, MO 64082-4833
Phone
(816) 809-4509
NPI assigned
Jun 30, 2011
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 05-37247 KS
Internal Medicine Physician 207R00000X 2014014081 MO Primary

Addresses

Primary practice location

3808 SW Sandstone Dr
Lees Summit, MO 64082-4833

Mailing address

3808 SW Sandstone Dr
Lees Summit, MO 64082-4833
Phone (816) 809-4509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140717000437 MO Practitioner - Internal MedicinePractitioner - Hospitalist 2668698200 Reassigns benefits to 3 organizations
I20140717000994 KS Practitioner - Internal MedicinePractitioner - Hospitalist 2668698200 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curana Health of Missouri-Kansas LLCGroup PAC ID 4789716531, 143 clinicians
CH Specialty Services Mo LLCGroup PAC ID 0345614459, 108 clinicians
CH Specialty Services KS LLCGroup PAC ID 6800261819, 65 clinicians

Practice addresses (Care Compare)

2885 Technology Dr
Lake St Louis, MO 63367-4123
Phone (337) 991-9276

400 SW Longview Blvd
Suite 200
Lees Summit, MO 64081-2116
Phone (337) 991-9276

9100 Park St
Lenexa, KS 66215-3353
Phone (816) 822-0050

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
CH Specialty Services Mo LLC Internal Medicine CurrentSince Feb 14, 2024 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Oct 27, 2014 Accepting new patients
Curana Health of Missouri-Kansas LLC CurrentSince Feb 14, 2024 Accepting new patients
Saint Lukes Hospital of Garnett Inc CurrentSince Jan 1, 2018 Accepting new patients
Saint Lukes Hospital of Garnett Inc CurrentSince Jan 1, 2018 Accepting new patients
CH Specialty Services KS LLC Internal Medicine CurrentSince Feb 14, 2024 Accepting new patients
Saint Lukes Hospital of Chillicothe CurrentSince Oct 27, 2014 Accepting new patients
CCRC of Overland Park, LLC Past Accepting new patients
Village Shalom, Inc Past Accepting new patients
Osage Valley Healthcare LLC Past Accepting new patients

Locations

421 S Maple St
Garnett, KS 66032
Phone (785) 204-7105

12724 State Line Rd
Leawood, KS 66209
Phone (913) 345-8808

9100 Park St
Lenexa, KS 66215
Phone (913) 888-1900

9100 Park St
Ste 280
Lenexa, KS 66215

2799 N Washington St
Chillicothe, MO 64601
Phone (660) 214-8300

2323 E 63rd St
Kansas City, MO 64130
Phone (816) 444-8161

2885 Technology Dr
Lake St Louis, MO 63367
Phone (314) 259-1044

400 SW Longview Blvd
Ste 200
Lees Summit, MO 64081
Phone (816) 477-7200

11278 Schuetz Rd
Saint Louis, MO 63146
Phone (314) 991-4066

1101 W Clay Rd
Versailles, MO 65084
Phone (573) 378-5312

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Nexdine HospitalityOverland Park, KS, CCN 175441 Skilled nursing facility Adp of the SNF Mar 1, 2024
Hillside Village of de Soto Rehabilitation and Nursing CenterDe Soto, KS, CCN 175472 Skilled nursing facility Operational/Managerial Control
Managing Control - Governing Body
Adp of the SNF		 May 1, 2024
May 1, 2024
Apr 9, 2026
Raintree VillageLee's Summit, MO, CCN 265888 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2025
Feb 1, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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 15

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1811284607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3808 SW SANDSTONE DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824833",
            "telephone_number": "816-809-4509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 SW SANDSTONE DR",
            "city": "LEES SUMMIT",
            "state": "MO",
            "postal_code": "640824833",
            "telephone_number": "816-809-4509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JESSICA",
        "middle_name": "NICOLE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "05-37247",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2014014081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee's Summit, MO

Sources for this page

Verify at the official NPI Registry.