Active NPI
Jonathan Lee
- Orthopedic Physical Therapist
- Marianna, FL
National Provider Identifier
1003352097
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 32134
- Practice address
- 4387 Kelson Ave Apt a
Marianna, FL 32446 - Phone
- (352) 870-8109
- NPI assigned
- Jan 13, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 32134 | FL | Primary |
Addresses
Primary practice location
4387 Kelson Ave Apt a
Marianna, FL 32446
Mailing address
4387 Kelson Ave Apt a
Marianna, FL 32446
Phone (352) 870-8109
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 |
|---|---|---|---|
| 32134 | FL | MD | Orthopedic Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1484265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493596800000",
"number": "1003352097",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4387 KELSON AVE APT A",
"city": "MARIANNA",
"state": "FL",
"postal_code": "32446",
"telephone_number": "352-870-8109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4387 KELSON AVE APT A",
"city": "MARIANNA",
"state": "FL",
"postal_code": "32446",
"telephone_number": "352-870-8109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JONATHAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-13",
"last_updated": "2017-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "FL",
"license": "32134",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marianna, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.