Individual provider Active NPI

Jonathan Edward Lee, MD

  • Anesthesiology Physician
  • Conway, AR
National Provider Identifier
1992924203
Registry record updated Jul 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
E-4718 Issued in AR
Practice address
2302 College Ave
Conway, AR 72034-6297
Phone
(501) 327-6665
Fax
(501) 730-0289
NPI assigned
Apr 25, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X E-4718 AR Primary

Addresses

Primary practice location

2302 College Ave
Conway, AR 72034-6297

Mailing address

2425 Prince St Ste 4
Conway, AR 72034-3701
Phone (501) 327-6665

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070808000068 AR Practitioner - Anesthesiology 1254422090 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Arkansas College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Anesthesiology Consultants, PAGroup PAC ID 6901796267, 22 clinicians

Practice addresses (Care Compare)

2302 College Ave
Conway, AR 72034-6297
Phone (501) 327-6665

Hospital & facility affiliations

  • Conway Regional Medical Center, Inc Hospital, Conway, AR, CCN 040029

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
E-4718ARMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Conway Anesthesiology Consultants, P.a. Anesthesiology CurrentSince Mar 21, 2016 Accepting new patients
Conway Regional Medical Center Inc CurrentSince Jan 8, 2018 Accepting new patients
Conway Regional Medical Center, Inc. Current Accepting new patients
Conway Regional Medical Center, Inc CurrentSince Jan 8, 2018 Accepting new patients
Conway Regional Medical Center Inc Past Accepting new patients

Locations

525 Western Ave
Ste 304
Conway, AR 72034
Phone (501) 327-7555

2425 Prince St
Ste 4
Conway, AR 72034
Phone (501) 327-6665

2302 College Ave
Conway, AR 72034
Phone (501) 329-3831

2200 Ada Ave
Ste 301
Conway, AR 72034
Phone (501) 358-6560

Organizations & group practices 5

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.

Hospital & facility affiliations 6

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": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562544000000",
    "number": "1992924203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2425 PRINCE ST STE 4",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720343701",
            "telephone_number": "501-327-6665",
            "fax_number": "501-730-0289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2302 COLLEGE AVE",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720346297",
            "telephone_number": "501-327-6665",
            "fax_number": "501-730-0289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JONATHAN",
        "middle_name": "EDWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2019-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "E-4718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

Verify at the official NPI Registry.