Individual provider Active NPI

Lee Ann Harris, PT

  • Physical Therapist
  • Prattville, AL
National Provider Identifier
1396309480
Registry record updated Oct 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH1005 Issued in AL
Practice address
1300 E Main St Ste a
Prattville, AL 36066-5528
Phone
(334) 568-2121
NPI assigned
Apr 24, 2019
Last updated
Oct 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH1005 AL Primary

Addresses

Primary practice location

1300 E Main St Ste a
Prattville, AL 36066-5528

Mailing address

240 Dogwood Ridge Dr
Wetumpka, AL 36093-1928
Phone (334) 478-3113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201118000041 AL Practitioner - Physical Therapist in Private Practice 5395156624 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH1005ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
River Region Physical Therapy, LLC Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients

Locations

1300 E Main St
Ste A
Prattville, AL 36066
Phone (334) 568-2121

266 Interstate Commercial Park Loop
Prattville, AL 36066
Phone (334) 568-2121

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, 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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603843200000",
    "number": "1396309480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 DOGWOOD RIDGE DR",
            "city": "WETUMPKA",
            "state": "AL",
            "postal_code": "360931928",
            "telephone_number": "334-478-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 E MAIN ST STE A",
            "city": "PRATTVILLE",
            "state": "AL",
            "postal_code": "360665528",
            "telephone_number": "334-568-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LEE",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2020-10-28",
        "certification_date": "2020-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH1005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prattville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2020; 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.