Individual provider Active NPI

Latoya Jean Lee, MD

  • Family Medicine Physician
  • Atlanta, GA
National Provider Identifier
1881033207
Registry record updated Oct 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
76289 Issued in GA
Practice address
1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649
Phone
(404) 836-0136
Fax
(404) 753-5266
NPI assigned
Jun 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL35942 SC
Family Medicine Physician 207Q00000X 76289 GA Primary

Addresses

Primary practice location

1325 Ralph David Abernathy Blvd SW
Atlanta, GA 30310-1649

Mailing address

3371 Buford Hwy NE
Brookhaven, GA 30329-1709
Phone (404) 836-0230

Other practice location 1

3371 Buford Hwy NE
Brookhaven, GA 30329
Phone (404) 836-0230

Other identifiers 1

IdentifierTypeStateIssuer
76289OtherGAGA PROVIDER LICENSE- MD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160928000207 GA Practitioner - Family Practice 5698083673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Meharry Medical College School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Southeast Permanente Medical GroupGroup PAC ID 6204829013, 823 clinicians

Practice addresses (Care Compare)

3495 Piedmont Rd NE
Atlanta, GA 30305-1729
Phone (404) 364-7206

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76289GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Southeast Permanente Medical Group Family Medicine CurrentSince Feb 4, 2024 Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Family Medicine Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

1175 Cascade Pkwy SW
Atlanta, GA 30311
Phone (404) 505-4006

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

2400 Mount Zion Pkwy
Jonesboro, GA 30236
Phone (770) 603-3649

Interoperability endpoints

  • Direct secure messaging: latoya.lee.1@30520.direct.athenahealth.com

Organizations & group practices 5

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": "1371600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1881033207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3371 BUFORD HWY NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303291709",
            "telephone_number": "404-836-0230",
            "fax_number": "305-698-6536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 RALPH DAVID ABERNATHY BLVD SW",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303101649",
            "telephone_number": "404-836-0136",
            "fax_number": "404-753-5266"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3371 Buford Hwy NE",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "30329",
            "country_code": "US",
            "telephone_number": "404-836-0230",
            "fax_number": "305-698-6536",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "LATOYA",
        "middle_name": "JEAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-19",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL35942",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "76289",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GA PROVIDER LICENSE- MD",
            "identifier": "76289",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.