Active NPI
Whitney T Lee, ATC
- Athletic Trainer
- Fort Walton Beach, FL
National Provider Identifier
1003104258
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- 0876
- Practice address
- 133 Magnolia Ave SE
Fort Walton Beach, FL 32548-7266 - Phone
- (623) 435-6300
- NPI assigned
- Jul 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 0876 | AZ | Primary |
Addresses
Primary practice location
133 Magnolia Ave SE
Fort Walton Beach, FL 32548-7266
Mailing address
8045 N 47TH Ave
Glendale, AZ 85302-6402
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0876 | AZ | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631232000000",
"number": "1003104258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8045 N 47TH AVE",
"city": "GLENDALE",
"state": "AZ",
"postal_code": "853026402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 MAGNOLIA AVE SE",
"city": "FORT WALTON BEACH",
"state": "FL",
"postal_code": "325487266",
"telephone_number": "623-435-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "WHITNEY",
"middle_name": "T",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-20",
"last_updated": "2021-09-10",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "AZ",
"license": "0876",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Walton Beach, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.