Individual provider Active NPI

Rebecca Lee, M.D.

  • Pediatrics Physician
  • Martinsburg, WV
National Provider Identifier
1902268477
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101274758 Issued in VA
Practice address
2000 Professional CT Ste C
Martinsburg, WV 25401-8803
Phone
(304) 263-8853
Fax
(304) 263-6178
NPI assigned
Mar 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 28864 WV
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X 0101274758 VA Primary

Addresses

Primary practice location

2000 Professional CT Ste C
Martinsburg, WV 25401-8803

Mailing address

2000 Professional CT Ste C
Martinsburg, WV 25401-8803
Phone (304) 263-8853

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20191001003338 WV Practitioner - Pediatric Medicine 7113211616 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101274758VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Healthcare Physicians, Inc. Single Specialty CurrentSince Jul 23, 2019 Accepting new patients
University Healthcare Physicians Inc Single Specialty CurrentSince Jul 23, 2019 Accepting new patients
Trusted Doctors LLC Single Specialty Past Accepting new patients
SSM Medical Group Inc. Past Accepting new patients

Locations

2000 Foundation Way
Ste 3100
Martinsburg, WV 25401
Phone (304) 260-1436

61 Campus Dr
Ste 200
Martinsburg, WV 25404
Phone (304) 274-6343

2000 Professional Ct
Ste C
Martinsburg, WV 25401
Phone (304) 263-8853

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1458777600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1902268477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PROFESSIONAL CT STE C",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018803",
            "telephone_number": "304-263-8853",
            "fax_number": "304-263-6178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PROFESSIONAL CT STE C",
            "city": "MARTINSBURG",
            "state": "WV",
            "postal_code": "254018803",
            "telephone_number": "304-263-8853",
            "fax_number": "304-263-6178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "REBECCA",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-24",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "28864",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101274758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Martinsburg, WV

Sources for this page

Verify at the official NPI Registry.