NPIMap

Organization Active NPI

Psychiatry Lee and Associates PC

  • Psychiatry Physician
  • Fort Dodge, IA
National Provider Identifier
1891756912
Registry record updated Feb 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
21456 Issued in IA
Legal business name
PSYCHIATRY LEE AND ASSOCIATES PC
Practice address
804 Kenyon Road
Suite a
Fort Dodge, IA 50501-5742
Phone
(515) 574-6120
Fax
(515) 574-6125
NPI assigned
Mar 29, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2012

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

Authorized official

Name
Dr. Sang Oug Lee, MD
Title
Owner Medical Director
Phone
(515) 574-6120

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 00596 IA
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X 21456 IA Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X I059525 IA

Addresses

Primary practice location

804 Kenyon Road
Suite a
Fort Dodge, IA 50501-5742

Mailing address

804 Kenyon Road
Suite a
Fort Dodge, IA 50501-5742
Phone (515) 574-6120

Other identifiers 2

IdentifierTypeStateIssuer
0091223MedicaidIA
10195OtherIABLUE CROSS BLUE SHIELD

Other names 1

  • Lee & Associates Doing business as

National Provider Directory

National Provider Directory

Locations

804 Kenyon Rd
Ste A
Fort Dodge, IA 50501
Phone (515) 574-6120

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1891756912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 KENYON ROAD",
            "address_2": "SUITE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015742",
            "telephone_number": "515-574-6120",
            "fax_number": "515-574-6125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 KENYON ROAD",
            "address_2": "SUITE A",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505015742",
            "telephone_number": "515-574-6120",
            "fax_number": "515-574-6125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PSYCHIATRY LEE AND ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-29",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "SANG",
        "authorized_official_middle_name": "OUG",
        "authorized_official_title_or_position": "OWNER MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "515-574-6120",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "00596",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IA",
            "license": "21456",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "I059525",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0091223",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "10195",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee & Associates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; 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.