Individual provider Active NPI

Blair C Lee, M.D.

  • Student in an Organized Health Care Education/Training Program
  • Norfolk, VA
National Provider Identifier
1912218173
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
825 Fairfax Ave Ste 610
Norfolk, VA 23507-1914
Phone
(757) 446-8960
NPI assigned
Jun 23, 2010
Last updated
Apr 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU Primary
Surgery Physician 208600000X 0101250184 VA
General Practice Physician 208D00000X 0101250184 VA

Addresses

Primary practice location

825 Fairfax Ave Ste 610
Norfolk, VA 23507-1914

Mailing address

3500 Vernon Mills CT
Chesapeake, VA 23323-1260

Other practice location 1

2790 Godwin Blvd Ste 305
Suffolk, VA 23434-8158
Phone (757) 934-4222

Other practice location 2

620 John Paul Jones Cir
Portsmouth, VA 23708-2197
Phone (757) 953-0669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240426002079 VA Practitioner - General Surgery 1254771066 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101250184VAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sentara Medical Group CurrentSince Apr 1, 2024 Accepting new patients
Evms Academic Physicians and Surgeons Health Services Foundation Surgery PastSince Apr 13, 2025 Accepting new patients

Locations

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

2790 Godwin Blvd
Ste 305
Suffolk, VA 23434
Phone (757) 934-4222

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1912218173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 VERNON MILLS CT",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233231260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 FAIRFAX AVE STE 610",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235071914",
            "telephone_number": "757-446-8960"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2790 Godwin Blvd Ste 305",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234348158",
            "country_code": "US",
            "telephone_number": "757-934-4222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082197",
            "country_code": "US",
            "telephone_number": "757-953-0669",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "BLAIR",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-23",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101250184",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101250184",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

Verify at the official NPI Registry.