Active NPI
Andrea Marie Lee, PT
- Physical Therapist
- Upland, CA
National Provider Identifier
1427094689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21780
- Practice address
- 1422 Seminole Cir
Upland, CA 91784-8043 - Phone
- (205) 862-1926
- NPI assigned
- Jun 22, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTH3542 | AL | |
| Physical Therapist | 225100000X | 21780 | CA | Primary |
Addresses
Primary practice location
1422 Seminole Cir
Upland, CA 91784-8043
Mailing address
1422 Seminole Cir
Upland, CA 91784-8043
Phone (205) 862-1926
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51534040 | Other | AL | BLUE CROSS BLUE SHEILD |
Other names 1
- Andrea Marie Harrill
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 |
|---|---|---|---|
| 21780 | CA | MD | Addiction (Substance Use Disorder) Counselor |
| PTH3542 | AL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cornerstone Fitness and Wellness | Physical Therapist | Past | Accepting new patients |
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.
-
- Physical Therapist
- Clanton, AL
- NPI 1669478152
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636416000000",
"number": "1427094689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1422 SEMINOLE CIR",
"city": "UPLAND",
"state": "CA",
"postal_code": "917848043",
"telephone_number": "205-862-1926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1422 SEMINOLE CIR",
"city": "UPLAND",
"state": "CA",
"postal_code": "917848043",
"telephone_number": "205-862-1926"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "ANDREA",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-22",
"last_updated": "2021-11-09",
"certification_date": "2021-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH3542",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "21780",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHEILD",
"identifier": "51534040",
"state": "AL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "HARRILL",
"middle_name": "MARIE",
"credential": "PT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Upland, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.