Jordan Lee

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

65 Shenandoah Ave Ste 203
Daleville, VA 24083-3205

Phone

(540) 352-4304

Fax

(540) 591-7340

NPI assigned

May 16, 2018

Last updated

Dec 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidewater Physicians Multispecialty Group, PCGroup PAC ID 2860398526, 259 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BGFHDD

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.

• Tidewater Physicians Multispecialty Group PC

  • Family Medicine Physician
  • Newport News, VA
  • NPI 1902848294
  Medicare reassignment Care Compare group NPD
• Tidewater Physicians Multispecialty Group PC

  • Ambulatory Surgical Clinic/Center
  • Williamsburg, VA
  • NPI 1316790512
  NPD
• University Physical Therapy Limited Partnership

  • Physical Therapist
  • Daleville, VA
  • NPI 1104330190
  NPD (past)

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

{
    "created_epoch": "1526428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606953600000",
    "number": "1801386735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 DAVIS ST STE B",
            "city": "BLACKSBURG",
            "state": "VA",
            "postal_code": "240607009",
            "telephone_number": "540-352-4304",
            "fax_number": "504-591-7340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "65 SHENANDOAH AVE STE 203",
            "city": "DALEVILLE",
            "state": "VA",
            "postal_code": "240833205",
            "telephone_number": "540-352-4304",
            "fax_number": "540-591-7340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-16",
        "last_updated": "2020-12-03",
        "certification_date": "2020-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211889",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kroger Limited Partnership I (Kroger Pharmacy)
• Amy C Kryder, MD
• Elizabeth Lamb, PHARMD
• Jennifer Larson, FNP
• Lawson Family Medicine and Aesthetics LLC (Lawson Family Medicine & Aesthetics)
• Lenk Family Orthodontics, Inc.
• Tayler Lynn Lewis, PT, DPT
• Lewisgale Medical Center, LLC (LewisGale Daleville Imaging)
• Tanesha L Love
• Kyle William Matyger, PHARMD

• Physical Therapist in Daleville, VA
• Providers in Daleville, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2020; 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.