Active NPI
David Lee
- Physical Therapist
- Roswell, GA
National Provider Identifier
1073486445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2025010675
- Practice address
- 4401 Shallowford Rd Ste Roswell
Roswell, GA 30075-3193 - Phone
- (678) 439-0894
- NPI assigned
- Sep 24, 2025
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2025010675 | MO | Primary |
Addresses
Primary practice location
4401 Shallowford Rd Ste Roswell
Roswell, GA 30075-3193
Mailing address
804 Lexington Rd
Monett, MO 65708-1072
Phone (417) 489-3854
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 |
|---|---|---|---|
| 2025010675 | MO | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1758672000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1758672000000",
"number": "1073486445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 LEXINGTON RD",
"city": "MONETT",
"state": "MO",
"postal_code": "657081072",
"telephone_number": "417-489-3854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4401 SHALLOWFORD RD STE ROSWELL",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300753193",
"telephone_number": "678-439-0894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DAVID",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-09-24",
"last_updated": "2025-09-24",
"certification_date": "2025-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "MO",
"license": "2025010675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.