Active NPI
Phuong K. Lee, APN
- Nurse Practitioner
- Bryn Mawr, PA
National Provider Identifier
1992880082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- TP003162J
- Practice address
- Bryn Mawr Hospital
130 S. Bryn Mawr Ave.
Bryn Mawr, PA 19010-3121 - Phone
- (610) 581-7570
- Fax
- (610) 581-7580
- NPI assigned
- Oct 26, 2006
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | TP003162J | PA | Primary |
| Neonatal Nurse Practitioner | 363LN0000X | TP003162J | PA | |
| Critical Care Neonatal Nurse Practitioner | 363LN0005X | TP003162J | PA | |
| Pediatric Nurse Practitioner | 363LP0200X | TP003162J | PA |
Addresses
Primary practice location
Bryn Mawr Hospital
130 S. Bryn Mawr Ave.
Bryn Mawr, PA 19010-3121
Mailing address
PO Box 191
Provider Enrollment Dept
Rockland, DE 19732-0191
Phone (302) 651-6212
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0008460 | Medicaid | NJ | |
| 4029283 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TP003162J | PA | MD | Neonatal Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317254400000",
"number": "1992880082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 191",
"address_2": "PROVIDER ENROLLMENT DEPT",
"city": "ROCKLAND",
"state": "DE",
"postal_code": "197320191",
"telephone_number": "302-651-6212",
"fax_number": "302-651-4945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BRYN MAWR HOSPITAL",
"address_2": "130 S. BRYN MAWR AVE.",
"city": "BRYN MAWR",
"state": "PA",
"postal_code": "190103121",
"telephone_number": "610-581-7570",
"fax_number": "610-581-7580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "PHUONG",
"middle_name": "K.",
"name_prefix": "Ms.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-26",
"last_updated": "2011-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "PA",
"license": "TP003162J",
"primary": true
},
{
"code": "363LN0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal",
"state": "PA",
"license": "TP003162J",
"primary": false
},
{
"code": "363LN0005X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Neonatal, Critical Care",
"state": "PA",
"license": "TP003162J",
"primary": false
},
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "PA",
"license": "TP003162J",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0008460",
"state": "NJ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "4029283",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bryn Mawr, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.