Individual provider Active NPI

Jason Donald Lee, PT

  • Physical Therapist
  • Augusta, GA
National Provider Identifier
1174858310
Registry record updated Oct 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007968 Issued in GA
Practice address
3650 J Dewey Gray Cir
Augusta, GA 30909-1867
Phone
(706) 863-9797
Fax
(706) 860-7686
NPI assigned
Oct 6, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT007968 GA
Physical Therapist 225100000X PT007968 GA Primary
Physical Therapist 225100000X PT.9934 SC

Addresses

Primary practice location

3650 J Dewey Gray Cir
Augusta, GA 30909-1867

Mailing address

PO Box 14039
Augusta, GA 30919-0039
Phone (706) 863-9797

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130809000339 GA Practitioner - Physical Therapist in Private Practice 9739321480 Reassigns benefits to 1 organization
I20191217002662 SC Practitioner - Physical Therapist in Private Practice 9739321480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Fox Rehabilitation Ga, LLCGroup PAC ID 6800162298, 109 clinicians

Practice addresses (Care Compare)

Duluth, GA 30097
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9934SCMDGeneral Practice Dentistry
PT007968GAMDPhysical Therapist
PT.9934SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Ga, LLC Physical Therapist CurrentSince Mar 8, 2020 Accepting new patients

Locations

7 Carnegie Plz
Cherry Hill, NJ 08003

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": "1254787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1174858310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14039",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309190039",
            "telephone_number": "706-863-9797",
            "fax_number": "706-860-7686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3650 J DEWEY GRAY CIR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309091867",
            "telephone_number": "706-863-9797",
            "fax_number": "706-860-7686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "middle_name": "DONALD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-10-06",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT007968",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007968",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT.9934",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.