Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 152W00000X | Optometrist | | GA002022 | GEORGIA | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | P00113847 | OTHER | GEORGIA | LEE RAILROADE MEDICARE ID |
| 2 | 1730168485 | OTHER | | NPI ELLERMAN |
| 3 | DB6414 | OTHER | GEORGIA | ELLERMAN MEDICARE RAILROAD GROUP |
| 4 | U63509 | MEDICARE UPIN | | |
| 5 | 41ZCFDZ | MEDICARE ID-TYPE UNSPECIFIED | GEORGIA | PERRY LEE OD |
| 6 | 41ZCFFB | MEDICARE ID-TYPE UNSPECIFIED | GEORGIA | ANGELA ELLERMAN OD |
| 7 | U92991 | MEDICARE UPIN | | |
| 8 | P00119368 | OTHER | GEORGIA | ELLERMAN RAILROAD MEDICARE ID |
| 9 | 000743399K | MEDICAID | GEORGIA | |
| 10 | 1679661250 | OTHER | | NPI PERRY LEE |
| 11 | CK7619 | OTHER | GEORGIA | LEE MEDICARE RAILROAD GROUP |
| 12 | 465525028A | MEDICAID | GEORGIA | |
