JOHNATHAN TYREE DIETRICH LEE


Address: 6333 Center Dr, Interstate Corporate Center # 16, Norfolk, VA 23502-4126
Phone: 5404480719

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
Physician Assistants & Advanced Practice Nursing Providers

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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

Office Location

Street Address 6333 CENTER DR
INTERSTATE CORPORATE CENTER # 16
City NORFOLK
State VA
Zip Code 23502-4126

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

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
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Competitor

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City NORFOLK
Zip Code 23502

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Dataset Information

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.

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