Jeremy Lee, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

295591 Issued in CA

Practice address

15632 Bear Valley Rd Ste 108
Victorville, CA 92395-8518

Phone

(760) 552-4230

NPI assigned

Sep 28, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jeremy Chang Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Wave Physical Therapy Inc

  • Physical Therapist
  • Victorville, CA
  • NPI 1497230759
  NPD (past)

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552348800000",
    "number": "1326523929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15632 BEAR VALLEY RD STE 108",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958518",
            "telephone_number": "248-229-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15632 BEAR VALLEY RD STE 108",
            "city": "VICTORVILLE",
            "state": "CA",
            "postal_code": "923958518",
            "telephone_number": "760-552-4230"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15610 Bear Valley Rd Ste A",
            "address_purpose": "LOCATION",
            "city": "Victorville",
            "state": "CA",
            "postal_code": "923958822",
            "country_code": "US",
            "telephone_number": "760-245-9999",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "399 E Highland Ave",
            "address_purpose": "LOCATION",
            "city": "San Bernardino",
            "state": "CA",
            "postal_code": "924043808",
            "country_code": "US",
            "telephone_number": "248-229-0864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-28",
        "last_updated": "2019-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "CA",
            "license": "295591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEREMY",
            "last_name": "CHANG",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Benjamin Lee I
• Eunice Lee, PHARMD
• Felix Lee, D.C.
• Jae Young Lee
• Jason Lee
• Joanne Juyoun Lee, PHARMD, RPH
• John Myung Lee, MD
• Kevin Patrick Lee
• Kevin Seokjong Lee, DDS
• Micah Lee

• Orthopedic Physical Therapist in Victorville, CA
• Providers in Victorville, CA by specialty
• Orthopedic Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 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.