Individual provider Active NPI

Kristen McCoy Lee, PT

  • Physical Therapist
  • Wilmington, NC
National Provider Identifier
1477839686
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P2763 Issued in NC
Practice address
3901 Wrightsville Ave Ste 120
Wilmington, NC 28403-6256
Phone
(910) 679-8385
NPI assigned
Nov 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 2763 NC
Physical Therapist 225100000X P2763 NC Primary

Addresses

Primary practice location

3901 Wrightsville Ave Ste 120
Wilmington, NC 28403-6256

Mailing address

1011 Porters Neck Rd
Wilmington, NC 28411-9196
Phone (910) 566-1200

Other practice location 1

1011 Porters Neck Rd
Wilmington, NC 28411-9196
Phone (910) 566-1200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200615002517 NC Practitioner - Physical Therapist in Private Practice 2062834385 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2763NCMDChiropractor
P2763NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Coastline Therapy Group, LLC Physical Therapist CurrentSince Feb 12, 2025 Accepting new patients
Coastal Speech and Reading Center Past Accepting new patients

Locations

3901 Wrightsville Ave
Ste 120
Wilmington, NC 28403

4130 Oleander Dr
Ste 101
Wilmington, NC 28403

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": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1477839686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1011 PORTERS NECK RD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284119196",
            "telephone_number": "910-566-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 WRIGHTSVILLE AVE STE 120",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036256",
            "telephone_number": "910-679-8385"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 Porters Neck Rd",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284119196",
            "country_code": "US",
            "telephone_number": "910-566-1200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "KRISTEN",
        "middle_name": "MCCOY",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "NC",
            "license": "2763",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P2763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.