Individual provider Active NPI

Andrew Jeffery Lee, DPT

  • Physical Therapist
  • Pensacola, FL
National Provider Identifier
1922861285
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT41187 Issued in FL
Practice address
707 E Cervantes St Ste B216
Pensacola, FL 32501-3286
Phone
(850) 912-9203
NPI assigned
Jan 31, 2024
Last updated
Mar 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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 2305216278 VA
Physical Therapist 225100000X PT41187 FL Primary

Addresses

Primary practice location

707 E Cervantes St Ste B216
Pensacola, FL 32501-3286

Mailing address

740 Hannas Ter
Pensacola, FL 32506-8479
Phone (540) 520-8527

Other practice location 1

20311 Timberlake Rd Ste B
Lynchburg, VA 24502-7203
Phone (434) 237-6812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240808003081 VA Practitioner - Physical Therapist in Private Practice 8022555945 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT41187FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Rehabilitation Associates of Central Virginia Limited Partnership Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Rehabilitation Associates of Central Virginia, Inc. Physical Therapist PastSince Oct 1, 1997 Accepting new patients

Locations

1111 Corporate Park Dr
Ste B
Forest, VA 24551
Phone (434) 525-4851

20311 Timberlake Rd
#B
Lynchburg, VA 24502
Phone (434) 237-6812

20311B Timberlake Rd
Lynchburg, VA 24502
Phone (434) 237-6812

20347 Timberlake Rd
Ste B
Lynchburg, VA 24502
Phone (434) 237-6812

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1706659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1922861285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 HANNAS TER",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325068479",
            "telephone_number": "540-520-8527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E CERVANTES ST STE B216",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325013286",
            "telephone_number": "850-912-9203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20311 Timberlake Rd Ste B",
            "address_purpose": "LOCATION",
            "city": "Lynchburg",
            "state": "VA",
            "postal_code": "245027203",
            "country_code": "US",
            "telephone_number": "434-237-6812",
            "fax_number": "434-509-1695",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEE",
        "first_name": "ANDREW",
        "middle_name": "JEFFERY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-31",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305216278",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT41187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pensacola, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.