Individual provider Active NPI

Korey Lee

  • Physical Therapist
  • Bismarck, ND
National Provider Identifier
1083540496
Registry record updated Jun 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2929 Issued in ND
Practice address
1040 Canada Ave Ste 1
Bismarck, ND 58503-1813
Phone
(701) 751-3064
Fax
(701) 751-2265
NPI assigned
Jun 23, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2929 ND Primary

Addresses

Primary practice location

1040 Canada Ave Ste 1
Bismarck, ND 58503-1813

Mailing address

1040 Canada Ave Ste 1
Bismarck, ND 58503-1813
Phone (701) 751-3064

Other practice location 1

4524 Memorial Hwy Unit 107
Mandan, ND 58554-4771
Phone (701) 712-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1040 Canada Ave
Suite 1
Bismarck, ND 58503-1813

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimum Therapies of North Dakota, Inc CurrentSince Jun 15, 2026 Accepting new patients
Optimum Therapies of North Dakota, Inc Physical Therapist CurrentSince Jun 15, 2026 Accepting new patients

Locations

1040 Canada Ave
#1
Bismarck, ND 58503
Phone (701) 590-0316

4524 Memorial Hwy
Unit 107
Mandan, ND 58554
Phone (701) 751-3064

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1782172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782172800000",
    "number": "1083540496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1040 CANADA AVE STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031813",
            "telephone_number": "701-751-3064",
            "fax_number": "701-751-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1040 CANADA AVE STE 1",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585031813",
            "telephone_number": "701-751-3064",
            "fax_number": "701-751-2265"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4524 Memorial Hwy Unit 107",
            "address_purpose": "LOCATION",
            "city": "Mandan",
            "state": "ND",
            "postal_code": "585544771",
            "country_code": "US",
            "telephone_number": "701-712-0400",
            "fax_number": "701-751-2265",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KOREY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-06-23",
        "last_updated": "2026-06-23",
        "certification_date": "2026-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "2929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.