Knicole A Lee, DNP,FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN116307 Issued in GA

Practice address

224 Peachtree St
Baxley, GA 31513-8079

Phone

(912) 705-5483

Fax

(912) 705-5484

NPI assigned

Oct 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern Healthcare Collaboration, IncGroup PAC ID 8820442247, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bacon County Hospital Hospital, Alma, GA, CCN 111327

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JEEICD

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.

• Southern Healthcare Collaboration, Inc

  • Primary Care Nurse Practitioner
  • Baxley, GA
  • NPI 1750087490
  Medicare reassignment Care Compare group NPD Authorized official
• Southern Primary Care and Behavioral Health Services, LLC

  • Family Nurse Practitioner
  • Baxley, GA
  • NPI 1508584319
  NPD Authorized official
• Healthie Community Center LLC

  • Family Nurse Practitioner
  • Baxley, GA
  • NPI 1881228039
  NPD
• SMG-Occupational Health Clinic

  • Primary Care Clinic/Center
  • Reidsville, GA
  • NPI 1710678925
  NPD (past)
• The Baxley and Appling County Hospital Authority

  • Rural Health Clinic/Center
  • Baxley, GA
  • NPI 1073752143
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bacon County Health Services, Inc.

  • Critical Access Hospital
  • Alma, GA
  • NPI 1629185285
  Care Compare affiliation

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

{
    "created_epoch": "1192406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1972791069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 PEACHTREE ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315138079",
            "telephone_number": "912-705-5483",
            "fax_number": "912-705-5484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 PEACHTREE ST",
            "city": "BAXLEY",
            "state": "GA",
            "postal_code": "315138079",
            "telephone_number": "912-705-5483",
            "fax_number": "912-705-5484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 152",
            "address_purpose": "LOCATION",
            "city": "Surrency",
            "state": "GA",
            "postal_code": "315630152",
            "country_code": "US",
            "telephone_number": "912-208-5608",
            "fax_number": "912-705-5484",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KNICOLE",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "DNP,FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-15",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN116307",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332370125G",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Miya Kennedy-White, LPC
• Kevin O. Keown, M.D.
• Ernest Buford Kesler Jr., EDD
• Andrew Laves
• Dora Nayibe Laves, CMI
• Lisa Marie Assisted Living LLC
• Timothy Neal Lovett, O.D.
• Renea McCall
• Vanacia Latrell McCall, LPN
• Jonathan Cade McCullar

• Family Nurse Practitioner in Baxley, GA
• Providers in Baxley, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.