Individual provider Active NPI

Nikkol Lee, DPT

  • Physical Therapist
  • Tucson, AZ
National Provider Identifier
1497752042
Registry record updated Sep 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5617 Issued in AZ
Practice address
1657 W Grant Rd
Tucson, AZ 85745-1433
Phone
(520) 670-9558
Fax
(520) 382-5550
NPI assigned
Jun 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2010

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 5617 AZ Primary

Addresses

Primary practice location

1657 W Grant Rd
Tucson, AZ 85745-1433

Mailing address

5501 N Oracle Rd
Ste 101
Tucson, AZ 85704-3850
Phone (520) 293-5551

Other identifiers 1

IdentifierTypeStateIssuer
86059251885745B003OtherAZTRICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101029000146 AZ Practitioner - Physical Therapist in Private Practice 1850585316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

15410 S Mountain Pkwy
Suite 112
Phoenix, AZ 85044-6691
Phone (480) 940-8299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Sports Medicine & Rehabilitation, LLC Physical Therapist CurrentSince Dec 1, 2022 Accepting new patients
Foothills Sports Medicine & Rehabilitation, LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

6788 S Kings Ranch Rd
Ste 4
Gold Canyon, AZ 85118
Phone (480) 982-1909

15410 S Mountain Pkwy
Ste 112
Phoenix, AZ 85044
Phone (480) 609-0822

1657 W Grant Rd
Tucson, AZ 85745
Phone (520) 670-9558

8770 N Thornydale Rd
Ste 100
Tucson, AZ 85742
Phone (520) 742-7107

3305 N Swan Rd
Ste 115
Tucson, AZ 85712
Phone (520) 321-0204

7601 N Oracle Rd
Ste 101
Tucson, AZ 85704
Phone (520) 293-5551

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": "1119916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283299200000",
    "number": "1497752042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 N ORACLE RD",
            "address_2": "STE 101",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857043850",
            "telephone_number": "520-293-5551",
            "fax_number": "520-293-6638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1657 W GRANT RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857451433",
            "telephone_number": "520-670-9558",
            "fax_number": "520-382-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "NIKKOL",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-28",
        "last_updated": "2010-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "5617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "86059251885745B003",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.