Individual provider Active NPI

Page Sookhyun Lee, NP

  • Primary Care Nurse Practitioner
  • Marietta, GA
National Provider Identifier
1881048973
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
APRN-NP229906 Issued in GA
Practice address
2480 Windy Hill Rd SE Ste 405
Marietta, GA 30067-8658
Phone
(800) 640-3451
NPI assigned
Apr 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X APRN-NP229906 GA Primary

Addresses

Primary practice location

2480 Windy Hill Rd SE Ste 405
Marietta, GA 30067-8658

Mailing address

PO Box 1200
Pleasant Grove, UT 84062-1200
Phone (800) 640-3451

Other identifiers 1

IdentifierTypeStateIssuer
003194549MedicaidGA

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170829003886 GA Practitioner - Nurse Practitioner 3971876756 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Emory University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Spencer J Hardenbrook MD PCGroup PAC ID 2062733546, 93 clinicians

Practice addresses (Care Compare)

2480 Windy Hill Rd SE
Suite 405
Marietta, GA 30067-8658
Phone (800) 640-3451

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-NP229906GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spencer J Hardenbrook MD PC CurrentSince Jan 15, 2026 Accepting new patients
Gwinnett Clinic, LTD PastSince May 22, 2022 Accepting new patients

Locations

2480 Windy Hill Rd SE
Ste 405
Marietta, GA 30067
Phone (770) 802-9687

Organizations & group practices 3

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": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1881048973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "PLEASANT GROVE",
            "state": "UT",
            "postal_code": "840621200",
            "telephone_number": "800-640-3451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 WINDY HILL RD SE STE 405",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678658",
            "telephone_number": "800-640-3451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "PAGE",
        "middle_name": "SOOKHYUN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-15",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "APRN-NP229906",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003194549",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.