Active NPI
Tyler Lee, PT
- Physical Therapist
- Cairo, GA
National Provider Identifier
1508873746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT005238
- Practice address
- 151 Martin Luther King Jr Ave SW
Cairo, GA 39828-2605 - Phone
- (229) 377-0882
- Fax
- (229) 377-0883
- NPI assigned
- Aug 1, 2006
- Last updated
- Dec 19, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT005238 | GA | Primary |
Addresses
Primary practice location
151 Martin Luther King Jr Ave SW
Cairo, GA 39828-2605
Mailing address
PO Box 523
Cairo, GA 39828-2605
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 116558 | Other | GA | MEDICARE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT005238 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Grady General Hospital | Past | Accepting new patients | |
| Thomasville Physical Therapy Inc | Past | Accepting new patients |
Interoperability endpoints
- https://fhir-myrecord.cerner.com/r4/66097e3b-7cef-4b96-acca-38bfaae85903/
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- General Acute Care Hospital
- Cairo, GA
- NPI 1013961507
-
- Physical Medicine & Rehabilitation Physician
- Thomasville, GA
- NPI 1598816290
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1198022400000",
"number": "1508873746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 523",
"city": "CAIRO",
"state": "GA",
"postal_code": "398282605"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 MARTIN LUTHER KING JR AVE SW",
"city": "CAIRO",
"state": "GA",
"postal_code": "398282605",
"telephone_number": "229-377-0882",
"fax_number": "229-377-0883"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "TYLER",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-01",
"last_updated": "2007-12-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT005238",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "116558",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cairo, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.