Individual provider Active NPI

Lee Edward Nagle, PT, DPT

  • Physical Therapist
  • Post Falls, ID
National Provider Identifier
1912925231
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-1842 Issued in ID
Practice address
104 W 9TH Ave
Post Falls, ID 83854-9216
Phone
(208) 777-9740
Fax
(208) 777-8316
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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 PT-1842 ID Primary

Addresses

Primary practice location

104 W 9TH Ave
Post Falls, ID 83854-9216

Mailing address

104 W 9TH Ave
Post Falls, ID 83854-9216
Phone (208) 777-9740

Other identifiers 1

IdentifierTypeStateIssuer
807091500MedicaidID

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040504000274 ID Practitioner - Physical Therapist in Private Practice 6507854072 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
In Touch Rehabilitation ServicesGroup PAC ID 6305924044, 5 clinicians

Practice addresses (Care Compare)

104 W 9TH Ave
Post Falls, ID 83854-9216
Phone (208) 777-9740

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
In Touch Physical Therapy and Sports Medicine Physical Therapist CurrentSince Jun 7, 2020 Accepting new patients
Physical Therapy Center of Post Physical Therapist PastSince Nov 30, 2001 Accepting new patients
Physical Therapy & Sports Medicine Institute Inc Physical Therapist Past Accepting new patients
Shellman Inc PA Physical Therapist PastSince Jan 1, 2001 Accepting new patients

Locations

104 W 9th Ave
Post Falls, ID 83854
Phone (208) 777-9740

Organizations & group practices 5

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1912925231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 W 9TH AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549216",
            "telephone_number": "208-777-9740",
            "fax_number": "208-777-8316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 W 9TH AVE",
            "city": "POST FALLS",
            "state": "ID",
            "postal_code": "838549216",
            "telephone_number": "208-777-9740",
            "fax_number": "208-777-8316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGLE",
        "first_name": "LEE",
        "middle_name": "EDWARD",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ID",
            "license": "PT-1842",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807091500",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Post Falls, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; 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.