CHARLES IVY LEE (NPI# 1255310363) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255310363 |
| Entity Type | Individual |
| Full Name | CHARLES IVY LEE |
| Credential | M.D. |
| Practice Address |
717 Pratt Ave Ne Huntsville AL 35801-3645 |
| Practice Telephone | 2568082273 |
| Mailing Telephone | 2568082273 |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2018-03-19 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | 00014864 | AL | Allopathic & Osteopathic Physicians |
| N | 207LA0401X |
Anesthesiology Specialization: Addiction Medicine |
14864 | AL | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | 14864 | AL | Allopathic & Osteopathic Physicians |
| N | 322D00000X | Residential Treatment Facility, Emotionally Disturbed Children | 14864 | AL | Residential Treatment Facilities |
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
14864 | AL | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | BCBS HH LOCATIONS | 51024029 | 01 |
| AL | 009975795 | 05 | |
| AL | BCBS- AL INDIV | 051019925 | 01 |
| AL | 000024029 | 05 | |
| AL | BCBS MADISON SURG CTR | 51523698 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 717 Pratt Ave Ne, Huntsville, AL 358013645 | 2568082273 | 2568082274 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275164097 | Charles L Lee II | Behavioral Analyst | 31194 Millbury Dr, Menifee, CA 92584-6617 | 2020-01-30 |
| 1043670854 | Charles Lee | Social Worker | 6654 Gilbert Pl, Shreveport, LA 71106-3425 | 2016-03-07 |
| 1245577212 | Charles Clifton Lee | Pharmacist | 1824 Hardman Ln, Woodstock, GA 30188-3103 | 2013-01-11 |
| 1336492891 | Charles J Lee | Dentist | 5005 N Piedras St Bldg 128, Dentac, El Paso, TX 79920-5001 | 2012-10-22 |
| 1306143847 | Charles Lee | Dentist | 7477 W Lake Mead Blvd, Ste 106, Las Vegas, NV 89128 | 2011-02-18 |
| 1902013915 | Charles Dudley Lee | Radiology | 16643 Maverick Ln, Poway, CA 92064-1613 | 2007-05-17 |
| 1003032061 | Charles C Lee | Dentist | 342 S Broadway, Escondido, CA 92025-4207 | 2007-04-18 |
| 1629115779 | Charles Mack Lee | Home Health Aide | 3919 E 147th St, Cleveland, OH 44128-1082 | 2007-01-30 |
| 1821143538 | Charles Churlmin Lee | Anesthesiology | 1711 Livingston Rd, Fort Meade, MD 20744 | 2007-01-24 |
| 1770645681 | Charles C Lee | Chiropractor | 20 E Northwest Hwy, Mt Prospect, IL 60056-3223 | 2006-12-15 |
| Street Address |
717 PRATT AVE NE |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-3645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396723128 | Propst Discount Drugs Inc | Durable Medical Equipment & Medical Supplies | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2006-01-03 |
| 1306348487 | Jacqueline Priscilla Green | Nurse Practitioner | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2018-03-05 |
| 1265965651 | Al Care First Inc | Clinic/Center | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2017-04-04 |
| 1760833214 | Michael Anthony Oddo | Pharmacist | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2016-06-27 |
| 1386089118 | Shelia Dianne Clopp | Nurse Practitioner | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2013-05-07 |
| 1104169176 | Lora Shuey Abernathy | Nurse Practitioner | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2013-03-28 |
| 1689985632 | Ernest Sheppard Campbell | General Practice | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2010-06-24 |
| 1437479789 | Quickcare Clinic LLC | Clinic/Center | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2010-06-09 |
| 1356540728 | Expressclinic, Inc | Family Medicine | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2007-07-16 |
| 1568526614 | Gary Boggus | Pharmacist | 717 Pratt Ave Ne, Huntsville, AL 35801-3645 | 2006-12-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528561974 | Stephen David Thrasher | General Practice | 2215 California St Se, Huntsville, AL 35801-2706 | 2018-03-12 |
| 1750837068 | Michelle R. Grana, Do; PC | General Practice | 470 Providence Main St Nw Ste 302a, Huntsville, AL 35806-4843 | 2016-08-27 |
| 1073964979 | Taurin Pyongkap Lee | General Practice | 2713 Downing St, Huntsville, AL 35801 | 2016-06-22 |
| 1952722738 | Carewell PC | General Practice | 5805 Lenlock Cir Se, Huntsville, AL 35802-1925 | 2013-12-23 |
| 1073851192 | Mary Barbara Sullivan | General Practice | 1403 Wind River Dr Se, Huntsville, AL 35802-3936 | 2013-01-24 |
| 1477810877 | Hung Trong Dao | General Practice | 829 10th Street, Huntsville, TX 77320-4721 | 2012-04-23 |
| 1144523648 | Anne Bauer, M.d., P.C. | General Practice | 204 Lowe Ave. Bldg 1 Suite 2, Huntsville, AL 35801 | 2010-12-06 |
| 1245449024 | Hayley Michelle Garner Degraaff | General Practice | 4245 Balmoral Dr Sw Ste 202, Huntsville, AL 35801-6497 | 2007-05-21 |
| 1851444368 | Valley Family Physician Care | General Practice | 1868 Sparkman Dr. Nw, Huntsville, AL 35816-1122 | 2007-01-19 |
| 1912006735 | American Family Care, Inc. | General Practice | 4550 University Drive, Huntsville, AL 35816 | 2006-09-21 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
Please comment or provide details below to improve the information on CHARLES IVY 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.