Individual provider Active NPI

Charles Churlmin Lee, MD

  • Anesthesiology Physician
  • Fort Meade, MD
National Provider Identifier
1821143538
Registry record updated Mar 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
D0053060 Issued in MD
Practice address
1711 Livingston Rd
Fort Meade, MD 20744
Phone
(301) 317-0020
Fax
(301) 317-0028
NPI assigned
Jan 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X D0053060 MD Primary

Addresses

Primary practice location

1711 Livingston Rd
Fort Meade, MD 20744

Mailing address

PO Box 639
Laurel, MD 20725
Phone (301) 317-0020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20040908000987 DC Practitioner - Anesthesiology 4587630892 Reassigns benefits to 1 organization
I20110111000117 MD Practitioner - Anesthesiology 4587630892 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0053060MDMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charles C Lee Anesthesia ,LLC Anesthesiology CurrentSince Oct 1, 2023 Accepting new patients
North American Partners in Anesthesia Maryland LLC Anesthesiology CurrentSince Dec 1, 2018 Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients

Locations

6430 Rockledge Dr
Ste 160
Bethesda, MD 20817
Phone (301) 312-6144

11711 Livingston Rd
Ft Washington, MD 20744
Phone (301) 203-2250

12200 Annapolis Rd
Ste 220
Glenn Dale, MD 20769
Phone (301) 699-2296

9 Park Center Ct
Ste 100
Owings Mills, MD 21117
Phone (410) 205-7667

5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727

2960 Technology Pl
Ste 103
Waldorf, MD 20601
Phone (301) 632-6092

68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107

Organizations & group practices 4

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": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362700800000",
    "number": "1821143538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 639",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20725",
            "telephone_number": "301-317-0020",
            "fax_number": "301-317-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1711 LIVINGSTON RD",
            "city": "FORT MEADE",
            "state": "MD",
            "postal_code": "20744",
            "telephone_number": "301-317-0020",
            "fax_number": "301-317-0028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHARLES",
        "middle_name": "CHURLMIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2013-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MD",
            "license": "D0053060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Meade, MD

Sources for this page

Verify at the official NPI Registry.