Individual provider Active NPI

Katie Juyoun Lee

  • Registered Nurse
  • Fresh Meadows, NY
National Provider Identifier
1821481698
Registry record updated Mar 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
580574 Issued in NY
Practice address
15849 76TH Rd
# 2B
Fresh Meadows, NY 11366-1012
Phone
(347) 574-2250
NPI assigned
Mar 18, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 580574 NY Primary

Addresses

Primary practice location

15849 76TH Rd
# 2B
Fresh Meadows, NY 11366-1012

Mailing address

15849 76TH Rd
# 2B
Fresh Meadows, NY 11366-1012
Phone (347) 574-2250

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

State licenses

LicenseStateTypeSpecialty
580574NYMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1821481698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15849 76TH RD",
            "address_2": "# 2B",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661012",
            "telephone_number": "347-574-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15849 76TH RD",
            "address_2": "# 2B",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113661012",
            "telephone_number": "347-574-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KATIE",
        "middle_name": "JUYOUN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "580574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.