JOHNATHAN TYREE DIETRICH LEE (NPI# 1790165686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1790165686 |
Entity Type | Individual |
Full Name | JOHNATHAN TYREE DIETRICH LEE |
Credential | PA-C |
Practice Address |
6333 Center Dr Interstate Corporate Center # 16 Norfolk VA 23502-4126 |
Practice Telephone | 5404480719 |
Mailing Telephone | 5404480719 |
Enumeration Date | 2015-06-04 |
Last Update Date | 2015-06-04 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780096016 | Johnathan Lee | Registered Nurse | 1010 Wisconsin Ave Nw, Washington, DC 20007-3603 | 2014-05-21 |
1437595162 | Johnathan Chungtae Lee | Community Health Worker | 13942 Ne Glisan St, Portland, OR 97230-3350 | 2013-05-21 |
1689815664 | Johnathan Lee | Surgery | 1800 12th St, 3rd Floor, Meridian, MS 39301-4158 | 2009-03-20 |
Street Address |
6333 CENTER DR INTERSTATE CORPORATE CENTER # 16 |
City | NORFOLK |
State | VA |
Zip Code | 23502-4126 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1417935636 | Urology of Virginia, PC | Urology | 6333 Center Dr, Bldg. 16, Norfolk, VA 23502-4126 | 2006-01-06 |
1982039699 | Kathryn Kelly Abbott | Dietitian, Registered | 6333 Center Dr, Bldg #16, Norfolk, VA 23502-4126 | 2013-09-12 |
1427303247 | Jessica Jennae Reed | Dietitian, Registered | 6333 Center Dr, Bldg 16, Norfolk, VA 23502-4126 | 2012-07-18 |
1447498498 | Heidi K Ross | Physical Therapy Assistant | 6333 Center Dr, Norfolk, VA 23502-4126 | 2009-01-29 |
1730331570 | Charlene N Reyes | Physician Assistant | 6333 Center Dr, Bldg 16, Norfolk, VA 23502-4126 | 2008-10-10 |
1366608788 | Sentara Medical Group | Surgery | 6333 Center Dr, Icc Bldg 16, Norfolk, VA 23502-4126 | 2008-08-05 |
1023290319 | Sentara Medical Group | Urology | 6333 Center Dr, Bldg 16, Norfolk, VA 23502-4126 | 2007-11-29 |
1922087972 | Steven M. Schlossberg | Urology | 6333 Center Dr, Bldg. 16, Norfolk, VA 23502-4106 | 2006-01-10 |
1497733505 | Rebekah A. Parker | Physical Therapist | 6333 Center Dr, Bldg. 16, Norfolk, VA 23502-4106 | 2006-01-09 |
1992783005 | Mary Allan F. Martinez | Nurse Practitioner | 6333 Center Dr, Bldg. 16, Norfolk, VA 23502-4106 | 2006-01-09 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1295210706 | Advantage Home Care, LLC | Home Health | 5353 E. Princess Anne Rd., Suite C, Norfolk, VA 23502 | 2018-10-01 |
1336627207 | Sentara Medical Group | Emergency Medicine | 844 Kempsville Rd Ste 103, Norfolk, VA 23502 | 2018-08-02 |
1548753833 | Murphy's Absolute Home Care LLC | Home Health | 983 Ingleside Rd Ste 6, Norfolk, VA 23502 | 2018-06-11 |
1487143939 | Valerie Sowder | Social Worker | 6275 E Virginia Beach Blvd Ste 301, Norfolk, VA 23502 | 2018-05-09 |
1164938841 | Accupoint Diagnostics | Clinical Medical Laboratory | 6161 Kempsville Cir Ste 202, Norfolk, VA 23502 | 2017-12-18 |
1467979351 | Lakeshia Louise Perryman | Counselor | 6325 N. Center Drive, Bldg 18, Suite 208, Norfolk, VA 23502 | 2017-08-23 |
1841536125 | Golden Touch Enterprise | Durable Medical Equipment & Medical Supplies | 5680 Lowey Rd, Unit 410b, Norfolk, VA 23502 | 2012-12-14 |
1497029011 | Kristine B Rand | Counselor | 6325 N Center Dr Ste 208, Norfolk, VA 23502 | 2012-02-29 |
1427343706 | Erica Leigh Streander | Pharmacist | 471 North Military Hwy, Norfolk, VA 23502 | 2011-06-14 |
1215239330 | Atlantic Physical Therapy | Specialist/Technologist | 5610 Lewis Rd, Norfolk, VA 23502 | 2010-11-22 |
Find all providers in zip 23502 |
Taxonomy Code | 363AM0700X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Physician Assistant |
Specialization | Medical |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679102347 | Mary Herrera | Physician Assistant | 6353 Center Dr Ste 204, Norfolk, VA 23502-0001 | 2020-04-05 |
1720614019 | Andrew James Meyers | Physician Assistant | 229 W Bute St Apt 207, Norfolk, VA 23510-1415 | 2020-03-18 |
1205345584 | Cassandra Lee Elverum | Physician Assistant | 600 Childrens Ln, Norfolk, VA 23507 | 2017-09-29 |
1790904456 | Thomas George Parish | Physician Assistant | 700 W Olney Rd, Norfolk, VA 23507-1607 | 2007-04-24 |
1649345372 | Ronald E Nave | Physician Assistant | 814 Kempsville Rd Ste 104, Norfolk, VA 23502-4001 | 2006-11-21 |
1073581823 | Karen Hintz Charlton | Physician Assistant | 1035 Nidar Blvd, Norfolk, VA 23521 | 2006-03-09 |
1902876931 | Mark Alan Gellasch | Physician Assistant | Branch Medical Clinic Norfolk, 1721 Taussig Blvd, Norfolk, VA 23511 | 2006-01-24 |
1073132551 | Ashley Makie | Physician Assistant | 3 Cedar St, Norfolk, MA 02056-1566 | 2020-04-14 |
1376179465 | Emily J Laughlin | Physician Assistant | 6379 Center Dr, Norfolk, VA 23502-4102 | 2020-03-20 |
1629604095 | Erin Anne Gray | Physician Assistant | 100 Kingsley Ln Ste 400, Norfolk, VA 23505-4604 | 2020-03-18 |
Find all providers in NORFOLK |
Please comment or provide details below to improve the information on JOHNATHAN TYREE DIETRICH LEE.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.