Active NPI
Melissa Dawn Lee, MS, OTR/L
- Occupational Therapist
- Peoria, AZ
National Provider Identifier
1194977462
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 4223
- Practice address
- 8506 W Deer Valley Rd Ste 105
Peoria, AZ 85382-5385 - Phone
- (623) 777-3113
- NPI assigned
- Oct 17, 2008
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | AZ | ||
| Occupational Therapist | 225X00000X | |||
| Occupational Therapist | 225X00000X | 4223 | AZ | Primary |
Addresses
Primary practice location
8506 W Deer Valley Rd Ste 105
Peoria, AZ 85382-5385
Mailing address
8506 W Deer Valley Rd Ste 105
Peoria, AZ 85382-5385
Phone (623) 777-3113
Other practice location 1
3609 N 27th St
Phoenix, AZ 85016-6747
Phone (919) 622-9015
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 810799952 | Other | AZ | MEDICARE |
| 810799952 | Medicaid | AZ | |
| 1396199477 | Medicaid | AZ |
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)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1194977462",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8506 W DEER VALLEY RD STE 105",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853825385",
"telephone_number": "623-777-3113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8506 W DEER VALLEY RD STE 105",
"city": "PEORIA",
"state": "AZ",
"postal_code": "853825385",
"telephone_number": "623-777-3113"
}
],
"practiceLocations": [
{
"address_1": "3609 N 27th St",
"address_purpose": "LOCATION",
"city": "Phoenix",
"state": "AZ",
"postal_code": "850166747",
"country_code": "US",
"telephone_number": "919-622-9015",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LEE",
"first_name": "MELISSA",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-17",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "AZ",
"license": "4223",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "810799952",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "810799952",
"state": "AZ"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396199477",
"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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.