NPIMap

Individual provider Active NPI

Kendra B. Lee, M.D.

  • Family Medicine Physician
  • Missoula, MT
National Provider Identifier
1982600359
Registry record updated Jun 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
11643 Issued in MT
Practice address
500 W Broadway St
Missoula, MT 59802-4008
Phone
(406) 721-5600
Fax
(406) 329-7524
NPI assigned
Jun 21, 2005
Last updated
Jun 25, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 11643 MT Primary

Addresses

Primary practice location

500 W Broadway St
Missoula, MT 59802-4008

Mailing address

PO Box 7609
Missoula, MT 59807-7609
Phone (406) 721-5600

Other identifiers 1

IdentifierTypeStateIssuer
8398992MedicaidWA

Other names 1

  • Kendra Beth Long Other name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address klee208735@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080710000357 MT Practitioner - Family Practice 2264493022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Washington School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Western Montana Clinic PCGroup PAC ID 2466365002, 44 clinicians

Practice addresses (Care Compare)

500 W Broadway St
Missoula, MT 59802-4008
Phone (406) 721-5600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.1 of 100Reported as group
Quality
86.66
Promoting interoperability
77
Improvement activities
40
Cost
72.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11643MTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Western Montana Clinic PC Current Accepting new patients
Western Montana Clinic PC CurrentSince Jul 31, 2008 Accepting new patients
N.a.T.I.V.E. Project Family Medicine Past Accepting new patients

Locations

500 W Broadway St
Missoula, MT 59802
Phone (406) 327-1918

Interoperability endpoints

  • Direct secure messaging: klee208735@wm.providencedirect.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624579200000",
    "number": "1982600359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7609",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598077609",
            "telephone_number": "406-721-5600",
            "fax_number": "406-721-3907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 W BROADWAY ST",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024008",
            "telephone_number": "406-721-5600",
            "fax_number": "406-329-7524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KENDRA",
        "middle_name": "B.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2021-06-25",
        "certification_date": "2021-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MT",
            "license": "11643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8398992",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klee208735@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "500 W Broadway St",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598024008",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KENDRA",
            "last_name": "LONG",
            "middle_name": "BETH",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.