NPIMap

Individual provider Active NPI

Lee O Fagre, MD

  • Family Medicine Physician
  • Waverly, IA
National Provider Identifier
1982649018
Registry record updated Jul 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24990 Issued in IA
Practice address
217 20TH St NW
Waverly, IA 50677-2017
Phone
(319) 352-9500
Fax
(319) 352-9509
NPI assigned
Jun 20, 2006
Last updated
Jul 13, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2007

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 24990 IA Primary

Addresses

Primary practice location

217 20TH St NW
Waverly, IA 50677-2017

Mailing address

2101 Kimball Ave
LL14
Waterloo, IA 50702-5063
Phone (319) 272-1590

Other identifiers 1

IdentifierTypeStateIssuer
3034843MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100322000825 IA Practitioner - Family PracticePractitioner - Geriatric Medicine 8527193044 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
University of Iowa, RJ & L Carver College of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Center IncGroup PAC ID 0244148732, 234 clinicians
Unified Therapy Services, IncGroup PAC ID 7618985714, 124 clinicians

Practice addresses (Care Compare)

217 20TH St NW
Mercyone Waverly Family Medicine
Waverly, IA 50677-2017
Phone (319) 352-9500

226 Bluebell Rd
Cedar Falls, IA 50613-6328
Phone (319) 575-5800

4135 Pennsylvania Ave
Dubuque, IA 52002-2628

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions31
Removal or shaving of skin growth1-10
Skin biopsy25

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
24990IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center Inc Family Medicine CurrentSince Jul 1, 1997 Accepting new patients
Covenant Medical Center, Inc. CurrentSince Jul 1, 1997 Accepting new patients
Floyd County Memorial Hospital Commission Family Medicine Past Accepting new patients

Locations

751 Main St
Arlington, IA 50606
Phone (563) 633-6965

226 Bluebell Rd
Cedar Falls, IA 50613
Phone (319) 575-5800

2101 Kimball Ave
#14
Waterloo, IA 50702

3421 W 9th St
Waterloo, IA 50702
Phone (319) 272-7050

217 20th St NW
Waverly, IA 50677
Phone (319) 352-9500

312 9th St SW
Waverly, IA 50677
Phone (319) 352-4120

Interoperability endpoints

  • Direct secure messaging: lfagre3932069@direct.trinity-health.org

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Clarksville Skilled Nursing and Rehabilitation CenterClarksville, IA, CCN 165495 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jul 1, 2016
Feb 25, 2026
Woodland TerraceWaverly, IA, CCN 165442 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Jun 1, 2000
Aug 5, 2025

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

  • Bartels Lutheran Home

    dba Bartels Lutheran Retirement Community / Woodland Terrace

    • Nursing Facility/Intermediate Care Facility
    • Waverly, IA
    • NPI 1013904432

    Adp of the SNF, Operational/Managerial Control

    CMS ownership
  • Community Nursing Home Inc

    dba Community Nursing Home

    • Skilled Nursing Facility
    • Clarksville, IA
    • NPI 1952307472

    Adp of the SNF, Operational/Managerial Control

    CMS ownership

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

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1150761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184284800000",
    "number": "1982649018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 KIMBALL AVE",
            "address_2": "LL14",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025063",
            "telephone_number": "319-272-1590",
            "fax_number": "319-272-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 20TH ST NW",
            "city": "WAVERLY",
            "state": "IA",
            "postal_code": "506772017",
            "telephone_number": "319-352-9500",
            "fax_number": "319-352-9509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGRE",
        "first_name": "LEE",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-20",
        "last_updated": "2007-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IA",
            "license": "24990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3034843",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waverly, IA

Sources for this page

Verify at the official NPI Registry.