Active NPI
Jong Soon Lee
- Registered Nurse
- Oak Park, MI
National Provider Identifier
1861222077
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1107659-30
- Practice address
- 22141 Whitmore St
Oak Park, MI 48237 - Phone
- (213) 949-9858
- NPI assigned
- Aug 2, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1107659-30 | WI | Primary |
Addresses
Primary practice location
22141 Whitmore St
Oak Park, MI 48237
Mailing address
109 Albemarle St Unit 301
Baltimore, MD 21202-4401
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1107659-30 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1861222077",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 ALBEMARLE ST UNIT 301",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212024401"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22141 WHITMORE ST",
"city": "OAK PARK",
"state": "MI",
"postal_code": "48237",
"telephone_number": "213-949-9858"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JONG",
"middle_name": "SOON",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-08-02",
"last_updated": "2024-08-02",
"certification_date": "2024-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "1107659-30",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.