Individual provider Active NPI

Lee W Boushell, DMD

  • General Practice Dentistry
  • Chapel Hill, NC
National Provider Identifier
1932233434
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7746 Issued in NC
Practice address
101 Brauer Hall CB # 7450
Chapel Hill, NC 27599-7450
Phone
(919) 966-1221
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7746 NC Primary
General Practice Dentistry 1223G0001X DN0012657 FL

Addresses

Primary practice location

101 Brauer Hall CB # 7450
Chapel Hill, NC 27599-7450

Mailing address

1605 Piperwood CT
Durham, NC 27713-4348

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191119002691 NC Practitioner - Dentist 6103128863 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN0012657FLMDGeneral Practice Dentistry
7746NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Current Accepting new patients
East Carolina University CurrentSince Oct 1, 2019 Accepting new patients
East Carolina University CurrentSince Oct 1, 2019 Accepting new patients
Dental Faculty Practice General Practice PastSince Jan 2, 1998 Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932233434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 PIPERWOOD CT",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277134348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BRAUER HALL CB # 7450",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997450",
            "telephone_number": "919-966-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSHELL",
        "first_name": "LEE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "7746",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0012657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.