Individual provider Active NPI

Lee Taylor Pinkham, DC

  • Sports Physician Chiropractor
  • Naples, FL
National Provider Identifier
1336845791
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
CH14405 Issued in FL
Practice address
6622 Willow Park Dr Ste 202
Naples, FL 34109-9016
Phone
(239) 745-5561
NPI assigned
Feb 6, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X CH14405 FL Primary

Addresses

Primary practice location

6622 Willow Park Dr Ste 202
Naples, FL 34109-9016

Mailing address

2100 Cherry Rd
Washington, NC 27889-7285
Phone (252) 945-7456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230314000880 FL Practitioner - Chiropractic 6204200389 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH14405FLMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gulf Coast Spine & Sport, LLC Sports Physician CurrentSince Feb 8, 2023 Accepting new patients

Locations

6622 Willow Park Dr
Ste 202
Naples, FL 34109
Phone (239) 745-5561

2240 Venetian Ct
Unit A
Naples, FL 34109
Phone (239) 745-5561

Organizations & group practices 1

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": "1675641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1336845791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 CHERRY RD",
            "city": "WASHINGTON",
            "state": "NC",
            "postal_code": "278897285",
            "telephone_number": "252-945-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6622 WILLOW PARK DR STE 202",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341099016",
            "telephone_number": "239-745-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKHAM",
        "first_name": "LEE",
        "middle_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-02-06",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "FL",
            "license": "CH14405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naples, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.