Active NPI
Jody Lee, DPT
- Physical Therapist
- Southfield, MI
National Provider Identifier
1356472658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21553
- Practice address
- 23800 W 10 Mile Rd Ste 193
Southfield, MI 48033-3194 - Phone
- (248) 827-1100
- Fax
- (248) 827-1120
- NPI assigned
- Mar 8, 2007
- Last updated
- Jun 29, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 21553 | MD | Primary |
Addresses
Primary practice location
23800 W 10 Mile Rd Ste 193
Southfield, MI 48033-3194
Mailing address
23800 W 10 Mile Rd Ste 193
Southfield, MI 48033-3194
Phone (248) 827-1100
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21553 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1593388800000",
"number": "1356472658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23800 W 10 MILE RD STE 193",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333194",
"telephone_number": "248-827-1100",
"fax_number": "248-827-1120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23800 W 10 MILE RD STE 193",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480333194",
"telephone_number": "248-827-1100",
"fax_number": "248-827-1120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "JODY",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-08",
"last_updated": "2020-06-29",
"certification_date": "2020-06-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "21553",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.