Individual provider Active NPI

Christopher Kyunyoung Lee, PT

  • Physical Therapist
  • Phoenix, AZ
National Provider Identifier
1518696350
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
LPT-32407 Issued in AZ
Practice address
5777 E Mayo Blvd
Phoenix, AZ 85054
Phone
(480) 301-8000
NPI assigned
Jun 7, 2022
Last updated
Feb 13, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X LPT-32407 AZ Primary

Addresses

Primary practice location

5777 E Mayo Blvd
Phoenix, AZ 85054

Mailing address

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 301-8000

Other practice location 1

4800 N 44th St
Phoenix, AZ 85018-3800
Phone (602) 808-8989

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address clee618920@ehrdirect.mayoclinicmsg.org

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

LicenseStateTypeSpecialty
LPT-32407AZMDPhysical Therapist

Interoperability endpoints

  • Direct secure messaging: clee618920@ehrdirect.mayoclinicmsg.org

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1654560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1518696350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85054",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5777 E MAYO BLVD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "85054",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 N 44th St",
            "address_purpose": "LOCATION",
            "city": "Phoenix",
            "state": "AZ",
            "postal_code": "850183800",
            "country_code": "US",
            "telephone_number": "602-808-8989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHRISTOPHER",
        "middle_name": "KYUNYOUNG",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-06-07",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-32407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "clee618920@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "5777 E Mayo Blvd",
            "city": "Phoenix",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "85054",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.