Active NPI
Angela Lee
- Occupational Therapy Assistant
- Peoria, AZ
National Provider Identifier
1174064208
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 224Z00000X
- Practice address
- 7028 W Lincoln St
Peoria, AZ 85345-6112 - Phone
- (623) 419-3652
- NPI assigned
- Mar 8, 2017
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 224Z00000X | AZ | Primary |
Addresses
Primary practice location
7028 W Lincoln St
Peoria, AZ 85345-6112
Mailing address
20435 N 7TH St
Phoenix, AZ 85024-6024
Phone (623) 419-3652
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| W2349 80498 | Other | AZ | AETNA |
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 |
|---|---|---|---|
| 224Z00000X | AZ | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1488931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493164800000",
"number": "1174064208",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20435 N 7TH ST",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850246024",
"telephone_number": "623-419-3652"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7028 W LINCOLN ST",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853456112",
"telephone_number": "623-419-3652"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ANGELA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-03-08",
"last_updated": "2017-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "AZ",
"license": "224Z00000X",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "W2349 80498",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peoria, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.