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JACK LEE
NPI 1578144044
Student in an Organized Health Care Education/Training Program in Fort Worth, TX

Active since April 16, 2021PECOS Enrolled
900 8TH AVE, FORT WORTH, TX 76104(817) 347-1140 Get Directions Write a Review

NPPES record last updated: April 16, 2021. Verified against the NPPES registry weekly; last sync: September 06, 2026.

About Jack Lee NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACK LEE (NPI 1578144044) is an individual student in an organized health care education/training program in Fort Worth, Texas and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1578144044
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJACK LEE
Location Address900 8TH AVEFort Worth, TX 76104-3902
Mailing Address900 8th AveFort Worth, TX 76104-3902 · (817) 347-1140
Phone(817) 347-1140
Sole ProprietorNo
Enumeration DateApril 16, 2021
NPPES CertifiedMarch 19, 2021
✔ NPI 1578144044 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
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.
900 8TH AVE, Fort Worth, TX 76104
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jack Lee is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RANDY NGUYEN DO
Internal Medicine
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 347-1140
JEREMY DEMITCHELL FNP-C
Nurse Practitioner (Family)
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 336-2100
ABIGAIL LEONARDO ABBAS DO
Student in an Organized Health Care Education/Training Program
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 347-1140
DAVID DANIEL TOLEDO BARRIOS DO
Student in an Organized Health Care Education/Training Program
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 347-1140
NGOZI LYNDA UMEZURIKE RN BSN
Nurse Practitioner (Adult Health)
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 834-8500
CAMILLA CANTUSIO MONTEIRO D.O.
Hospitalist
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 347-5887
HEMA PANDYA BOHRA D.O.
Internal Medicine
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 877-5292
TANNER LEN CLIMER
Nurse Anesthetist, Certified Registered
900 8TH AVE
FORT WORTH, TX 76104
Tarrant County (817) 336-2100

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Lee's NPI number?

The NPI number for Jack Lee is 1578144044. It was assigned to this individual provider in the NPPES registry on April 16, 2021.

Where is Jack Lee located?

Jack Lee practices at 900 8th Ave, Fort Worth, TX 76104. The listed phone number is (817) 347-1140.

What is Jack Lee's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jack Lee enrolled in Medicare?

Yes. Jack Lee is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jack Lee was last updated on April 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.