Active NPI
Thomas Van Dyke Lee, OT
- Occupational Therapist
- Greenville, NC
National Provider Identifier
1093969099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 0105
- Practice address
- 700B Cromwell Dr
Greenville, NC 27858-5852 - Phone
- (252) 756-0009
- Fax
- (252) 355-7358
- NPI assigned
- Nov 5, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 0105 | NC | Primary |
Addresses
Primary practice location
700B Cromwell Dr
Greenville, NC 27858-5852
Mailing address
700B Cromwell Dr
Greenville, NC 27858-5852
Phone (252) 756-0009
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 201947869 | Other | NC | TAX ID |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225843200000",
"number": "1093969099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700B CROMWELL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278585852",
"telephone_number": "252-756-0009",
"fax_number": "252-355-7358"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "700B CROMWELL DR",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278585852",
"telephone_number": "252-756-0009",
"fax_number": "252-355-7358"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "THOMAS",
"middle_name": "VAN DYKE",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-11-05",
"last_updated": "2008-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "0105",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "201947869",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.