KANGJUN LEE (NPI# 1467051516) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467051516 |
| Entity Type | Individual |
| Full Name | KANGJUN LEE |
| Practice Address |
901 S. National Ave. Springfield MO 65897 |
| Mailing Address |
821 E. Battlefield Rd. D39 Springfield MO 65807 |
| Practice Telephone | 4178368924 |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
901 S. NATIONAL AVE. |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65897 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134743073 | Jared Saylor | Student in an Organized Health Care Education/Training Program | 901 S National Ave, Prof 160, Springfield, MO 65897 | 2020-06-06 |
| 1215597208 | Jangsoo Kim | Student in an Organized Health Care Education/Training Program | 901 S National Ave., Springfield, MO 65897 | 2019-06-20 |
| 1104912542 | Filip John Garrett | Family Medicine | 901 S Nationa Ave, Springfield, MO 65897 | 2006-10-05 |
| 1043306483 | Lawrence Sylvester Shields | Family Medicine | 901 South National Ave, Springfield, MO 65897 | 2006-10-05 |
| 1154677912 | Samantha M Charters | Specialist | 901 S National Ave, Athletic Medical and Rehab, Springfield, MO 65897 | 2012-07-31 |
| 1669543112 | Sally Lynn Hubbard | Family Medicine | 901 S National Ave, Springfield, MO 65897 | 2006-11-13 |
| 1750469102 | Susan Wilson Essman | Family Medicine | 901 South National Avenue, Springfield, MO 65897 | 2006-11-02 |
| 1790862845 | Mary Annette Wardell | Family Medicine | 901 S National Ave, Taylor Health & Wellness Center, Springfield, MO 65897 | 2006-11-01 |
| 1043397169 | Shana Kristin Del Vecchio | Nurse Practitioner | 901 S National Ave, Taylor Health & Wellness Center, Springfield, MO 65897 | 2006-11-01 |
| 1073600334 | Missouri State University | Psychologist | 715 S Florence, Springfield, MO 65897 | 2006-10-06 |
| Find all providers in zip 65897 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538773361 | Aarika Danielle Gardner | Student in an Organized Health Care Education/Training Program | 560 W Bryant Apt D207, Springfield, MO 65810-8329 | 2020-08-31 |
| 1134743073 | Jared Saylor | Student in an Organized Health Care Education/Training Program | 901 S National Ave, Prof 160, Springfield, MO 65897 | 2020-06-06 |
| 1659995694 | Erin Bowler | Student in an Organized Health Care Education/Training Program | 51 Ingersoll Grv, Springfield, MA 01109-4010 | 2020-06-05 |
| 1063035483 | Mary Anne Iellamo | Student in an Organized Health Care Education/Training Program | 3400 Main St Fl 2, Springfield, MA 01199-1003 | 2020-05-20 |
| 1760005359 | Hannah Elizabeth Schumann | Student in an Organized Health Care Education/Training Program | 1621 E Lark St, Springfield, MO 65804-4351 | 2020-05-18 |
| 1962024109 | Brittany Nicole Campbell | Student in an Organized Health Care Education/Training Program | 2266 Boysenberry Ln Apt 4, Springfield, IL 62711-5414 | 2020-05-11 |
| 1518587286 | Emily Lyn Street | Student in an Organized Health Care Education/Training Program | 38 Country Pl, Springfield, IL 62703-5310 | 2020-04-22 |
| 1730709411 | Mary Kathleen Simon | Student in an Organized Health Care Education/Training Program | 1820 S Wiggins Ave, Springfield, IL 62704-3335 | 2020-04-22 |
| 1225658131 | Sarah Colby Mchugh | Student in an Organized Health Care Education/Training Program | 759 Chestnut St # S5427, Springfield, MA 01199-0001 | 2020-04-21 |
| 1346879889 | Ashly Seby | Student in an Organized Health Care Education/Training Program | 86 Redwood Rd Fl 3, Springfield, NJ 07081-2426 | 2020-04-06 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65897 |
Please comment or provide details below to improve the information on KANGJUN 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.