Individual provider Active NPI

Jason Lee

  • Physical Therapy Assistant
  • Washington, DC
National Provider Identifier
1194293548
Registry record updated Sep 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA000208 Issued in DC
Practice address
1120 20TH St NW Ste 116
Washington, DC 20036-3406
Phone
(202) 416-2110
NPI assigned
Nov 4, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapy Assistant 225200000X PTA000208 DC Primary

Addresses

Primary practice location

1120 20TH St NW Ste 116
Washington, DC 20036-3406

Mailing address

13420 Coachlamp LN
Silver Spring, MD 20906-5832
Phone (240) 286-5314

Other practice location 1

6401 America Blvd
Hyattsville, MD 20782-2357
Phone (855) 546-1740

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

LicenseStateTypeSpecialty
PTA000208DCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1541289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1194293548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13420 COACHLAMP LN",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209065832",
            "telephone_number": "240-286-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 20TH ST NW STE 116",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200363406",
            "telephone_number": "202-416-2110"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6401 America Blvd",
            "address_purpose": "LOCATION",
            "city": "Hyattsville",
            "state": "MD",
            "postal_code": "207822357",
            "country_code": "US",
            "telephone_number": "855-546-1740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JASON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-04",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "DC",
            "license": "PTA000208",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.