Active NPI
Emily Suzanne Lee, D.O.
- Pediatrics Physician
- Windham, NH
National Provider Identifier
1811332497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 23461
- Practice address
- 5 Industrial Dr Unit C
Windham, NH 03087-2021 - Phone
- (978) 577-0454
- NPI assigned
- May 8, 2013
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 23461 | NH | Primary |
| Pediatrics Physician | 208000000X | 277583 | MA |
Addresses
Primary practice location
5 Industrial Dr Unit C
Windham, NH 03087-2021
Mailing address
5 Industrial Dr Unit C
Windham, NH 03087-2021
Other names 1
- Emily Suzanne Proctor
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 277583 | MA | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elliot Physicians Network | Pediatrics | Current | Accepting new patients |
Locations
275 Mammoth Rd
Ste 1
Manchester, NH 03109
Phone (603) 663-3222
5 Industrial Dr
#C
Windham, NH 03087
Phone (603) 685-0150
Interoperability endpoints
- elee145410@direct.solutionhealth.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1367971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1811332497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 INDUSTRIAL DR UNIT C",
"city": "WINDHAM",
"state": "NH",
"postal_code": "030872021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5 INDUSTRIAL DR UNIT C",
"city": "WINDHAM",
"state": "NH",
"postal_code": "030872021",
"telephone_number": "978-577-0454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "EMILY",
"middle_name": "SUZANNE",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-08",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "NH",
"license": "23461",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "277583",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMILY",
"last_name": "PROCTOR",
"middle_name": "SUZANNE",
"credential": "DO",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Windham, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; 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.