Active NPI
Mark Alfred Lee, MPT, OMPT
- Physical Therapist
- Southfield, MI
National Provider Identifier
1912005919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5501008453
- Practice address
- 24011 Greenfield Rd
Southfield, MI 48075-3115 - Phone
- (248) 557-5440
- Fax
- (248) 557-2305
- NPI assigned
- Sep 21, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
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 | 5501008453 | MI | Primary |
Addresses
Primary practice location
24011 Greenfield Rd
Southfield, MI 48075-3115
Mailing address
26295 Pattow St
Roseville, MI 48066-3561
Phone (586) 771-9525
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 |
|---|---|---|---|
| 5501008453 | MI | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1912005919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "26295 PATTOW ST",
"city": "ROSEVILLE",
"state": "MI",
"postal_code": "480663561",
"telephone_number": "586-771-9525"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24011 GREENFIELD RD",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480753115",
"telephone_number": "248-557-5440",
"fax_number": "248-557-2305"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "MARK",
"middle_name": "ALFRED",
"name_prefix": "Mr.",
"credential": "MPT, OMPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MI",
"license": "5501008453",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.