Individual provider Active NPI

Kimberly K Lee, PT

  • Physical Therapist
  • Evansville, IN
National Provider Identifier
1275607442
Registry record updated Feb 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
05002357A Issued in IN
Practice address
5828 Pearl Dr
Evansville, IN 47712-8116
Phone
(812) 437-1420
Fax
(812) 437-1425
NPI assigned
Nov 20, 2006
Last updated
Feb 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4927 KY
Physical Therapist 225100000X 05002357A IN Primary

Addresses

Primary practice location

5828 Pearl Dr
Evansville, IN 47712-8116

Mailing address

PO Box 922
Evansville, IN 47706-0922
Phone (866) 309-5567

Other names 1

  • Kimberly K Will Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140121002036 AZ Practitioner - Physical Therapist in Private Practice 2567562390 Reassigns benefits to 1 organization
I20210922003456 IN Practitioner - Physical Therapist in Private Practice 2567562390 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oa Therapy LLCGroup PAC ID 7618006453, 24 clinicians

Practice addresses (Care Compare)

5828 Pearl Dr
Evansville, IN 47712-8116
Phone (812) 437-1420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Oa Therapy LLC Physical Therapist CurrentSince Sep 8, 2021 Accepting new patients
Affinity Physical Therapy LLC CurrentSince Nov 4, 2013 Accepting new patients
Your Physical Therapy Solutions,LLC Physical Therapist Past Accepting new patients

Locations

1491 N Arizona Blvd
Ste 109
Coolidge, AZ 85128
Phone (520) 424-2222

4050 E Cotton Center Blvd
Ste 18
Phoenix, AZ 85040
Phone (480) 653-8200

3519 N Green River Rd
Evansville, IN 47715
Phone (812) 437-1420

515 Read St
Evansville, IN 47710
Phone (812) 437-1420

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706745600000",
    "number": "1275607442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 922",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477060922",
            "telephone_number": "866-309-5567",
            "fax_number": "812-491-1269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5828 PEARL DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477128116",
            "telephone_number": "812-437-1420",
            "fax_number": "812-437-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "KIMBERLY",
        "middle_name": "K",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-20",
        "last_updated": "2024-02-01",
        "certification_date": "2024-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "4927",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05002357A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIMBERLY",
            "last_name": "WILL",
            "middle_name": "K",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evansville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2024; 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.