Individual provider Active NPI

Stormie Lee Lee, PT

  • Physical Therapist
  • Arlington, TX
National Provider Identifier
1477053791
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1302122 Issued in TX
Practice address
6033 W Interstate 20
Arlington, TX 76017-1042
Phone
(817) 483-1746
Fax
(817) 483-5874
NPI assigned
Feb 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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 1302122 TX Primary

Addresses

Primary practice location

6033 W Interstate 20
Arlington, TX 76017-1042

Mailing address

6033 W Interstate 20
Arlington, TX 76017-1042
Phone (817) 483-1746

Other practice location 1

384 SW Johnson Ave Ste A1
Burleson, TX 76028-5360
Phone (817) 483-1746

Other identifiers 1

IdentifierTypeStateIssuer
1302122OtherTXTEXAS BOARD OF PT EXAMINERS

Other names 1

  • Stormie Lee Bethel Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180416001053 TX Practitioner - Physical Therapist in Private Practice 0941563423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Blacketer Enterprises, IncGroup PAC ID 4981884905, 16 clinicians

Practice addresses (Care Compare)

6033 W Interstate 20
Therapy Excellence
Arlington, TX 76017-1042
Phone (817) 483-1746

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1302122TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blacketer Enterprises, Inc Physical Therapist CurrentSince Feb 5, 2018 Accepting new patients
Agape Physical Therapy Services, PC Physical Therapist PastSince Feb 5, 2018 Accepting new patients

Locations

6033 W Interstate 20
Arlington, TX 76017
Phone (817) 483-1746

244 SW Wilshire Blvd
Burleson, TX 76028
Phone (817) 483-1746

384 SW Johnson Ave
Ste A1
Burleson, TX 76028
Phone (817) 483-1746

Organizations & group practices 2

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": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1477053791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6033 W INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171042",
            "telephone_number": "817-483-1746",
            "fax_number": "817-483-5874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6033 W INTERSTATE 20",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760171042",
            "telephone_number": "817-483-1746",
            "fax_number": "817-483-5874"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "384 SW Johnson Ave Ste A1",
            "address_purpose": "LOCATION",
            "city": "Burleson",
            "state": "TX",
            "postal_code": "760285360",
            "country_code": "US",
            "telephone_number": "817-483-1746",
            "fax_number": "817-483-1746",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "STORMIE",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1302122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS BOARD OF PT EXAMINERS",
            "identifier": "1302122",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STORMIE",
            "last_name": "BETHEL",
            "middle_name": "LEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Arlington, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.