Individual provider Active NPI

Chan Gi Lee

  • Optometrist
  • Fort Liberty, NC
National Provider Identifier
1841969532
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
003348 Issued in GA
Practice address
2817 Rock Merritt Ave
Fort Liberty, NC 28310-6150
Phone
(703) 507-0879
NPI assigned
Sep 7, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 003348 GA Primary

Addresses

Primary practice location

2817 Rock Merritt Ave
Fort Liberty, NC 28310-6150

Mailing address

2817 Rock Merritt Ave
Fort Liberty, NC 28310-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620000084 NC Practitioner - Optometry 4385156975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

173 Grand Hill PL
Holly Springs, NC 27540-4415
Phone (919) 346-2062

1960 Randolph Rd
Charlotte, NC 28207-1129
Phone (704) 372-5332

3603 Davis Dr
Suite 100
Morrisville, NC 27560-6009
Phone (919) 234-4888

7020 Six Forks Rd
Raleigh, NC 27615-6430
Phone (919) 847-5957

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003348GAMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jun 21, 2025 Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist Current Accepting new patients
Myeyedr Optometry of North Carolina, PLLC Optometrist CurrentSince Jun 21, 2025 Accepting new patients
Myeyedr Optometry of North Carolina Optometrist Past Accepting new patients

Locations

800 W Williams St
Ste 164
Apex, NC 27502
Phone (919) 362-0332

1975 High House Rd
Cary, NC 27519
Phone (919) 461-0771

1960 Randolph Rd
Charlotte, NC 28207
Phone (704) 372-5332

173 Grand Hill Pl
Holly Springs, NC 27540
Phone (919) 346-2062

3603 Davis Dr
Ste 100
Morrisville, NC 27560
Phone (919) 234-4888

7020 Six Forks Rd
Raleigh, NC 27615
Phone (919) 847-5957

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

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, 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": "1630972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733270400000",
    "number": "1841969532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283100001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVE",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283106150",
            "telephone_number": "703-507-0879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHAN",
        "middle_name": "GI",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-07",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "003348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Liberty, NC

Sources for this page

Verify at the official NPI Registry.