Active NPI
Elizabeth Lee, PA-C
- Physician Assistant
- Chesterfield, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0010-04906
- Practice address
- 15740 S Outer 40 Rd
Chesterfield, MO 63017 - Phone
- (636) 237-4700
- NPI assigned
- Feb 10, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 2018039122 | MO | |
| Physician Assistant | 363A00000X | 0010-04906 | NC | Primary |
Addresses
Primary practice location
15740 S Outer 40 Rd
Chesterfield, MO 63017
Mailing address
30 Country Fair LN
Saint Louis, MO 63141-7805
Phone (925) 317-2078
Other practice location 1
3000 New Bern Ave
Raleigh, NC 27610-1231
Phone (919) 350-5332
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mercy Clinic Springfield Communities | Current | Accepting new patients | |
| Mercy Clinic Springfield Communities | Internal Medicine | Current | Accepting new patients |
| Mercy Clinic-Springfield Communities | Current | Accepting new patients |
Locations
15740 South Outer 40 Rd
Chesterfield, MO 63017
Phone (636) 735-4268
1605 Martin Springs Dr
Rolla, MO 65401
Phone (573) 458-6379
620 S Glenstone Ave
Springfield, MO 65802
Phone (417) 829-4215
2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905
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.
-
- Family Medicine Physician
- Springfield, MO
- NPI 1245277631
Internal Medicine
-
- Rural Health Clinic/Center
- Willow Springs, MO
- NPI 1972771657
-
- Eyewear Supplier
- Lebanon, MO
- NPI 1649477456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1391990400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1541548800000",
"number": "1922422013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 COUNTRY FAIR LN",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631417805",
"telephone_number": "925-317-2078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15740 S OUTER 40 RD",
"city": "CHESTERFIELD",
"state": "MO",
"postal_code": "63017",
"telephone_number": "636-237-4700"
}
],
"practiceLocations": [
{
"address_1": "3000 New Bern Ave",
"address_purpose": "LOCATION",
"city": "Raleigh",
"state": "NC",
"postal_code": "276101231",
"country_code": "US",
"telephone_number": "919-350-5332",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "ELIZABETH",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-02-10",
"last_updated": "2018-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MO",
"license": "2018039122",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NC",
"license": "0010-04906",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chesterfield, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.