NPI age
— years
Enumerated unknown
● Deactivated
Type 1 · Individual
Primary specialty
Healthcare provider
Licensed in
—
0 states
Status
Deactivated
Since 2026-10-07
Last NPPES update
—
Source: CMS NPPES provider record
Sole proprietor
Not specified
May be part of a larger org
NPI lifetime · → 2026
2026-10Deactivated
2026-10Last name changed
2026-10First name changed
2026-10Is active changed
2026-10Sole proprietor changed
2026
2026
Where they practice
Change history (from NPPES delta log)
-
2026-10-12Last name: LEE
-
2026-10-12First name: KIRSTIE
-
2026-10-12Is active: false (was true)
-
2026-10-12Sole proprietor: Y
Practice context
Solo or small practice. No other active providers share this practice address in NPPES.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.