Individual provider Active NPI

Lisa Le, MD

  • Family Medicine Physician
  • Morrow, GA
National Provider Identifier
1063916146
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
87291 Issued in GA
Practice address
1000 Corporate Center Dr Ste 200
Morrow, GA 30260-4129
Phone
(770) 968-6464
Fax
(770) 968-6455
NPI assigned
Mar 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 87291 GA Primary

Addresses

Primary practice location

1000 Corporate Center Dr Ste 200
Morrow, GA 30260-4129

Mailing address

1000 Corporate Center Dr Ste 200
Morrow, GA 30260-4129
Phone (770) 968-6464

Other practice location 1

303 Parkway Dr NE
Atlanta, GA 30312-1212
Phone (770) 968-6464

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lle171945@directwellstar.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210723000625 GA Practitioner - Family Practice 6608279955 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wellstar Medical Group LLCGroup PAC ID 6709065402, 3,059 clinicians

Practice addresses (Care Compare)

5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222

6002 Professional Pkwy
Douglasville, GA 30134-5627

8954 Hospital Dr
Douglasville, GA 30134-2272
Phone (678) 838-2585

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
87291GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wellstar Medical Group, LLC CurrentSince Jul 15, 2021 Accepting new patients
Wellstar Medical Group, LLC Family Medicine Current Accepting new patients
Douglas Hospital, Inc. Past Accepting new patients

Locations

303 Parkway Dr NE
Atlanta, GA 30312
Phone (404) 265-4000

5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222

805 Sandy Plains Rd
Marietta, GA 30066
Phone (770) 792-1616

1000 Corporate Center Dr
Ste 200
Morrow, GA 30260
Phone (770) 968-6464

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1521676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1063916146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR STE 200",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604129",
            "telephone_number": "770-968-6464",
            "fax_number": "770-968-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 CORPORATE CENTER DR STE 200",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "302604129",
            "telephone_number": "770-968-6464",
            "fax_number": "770-968-6455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "303 Parkway Dr NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303121212",
            "country_code": "US",
            "telephone_number": "770-968-6464",
            "fax_number": "770-968-6461",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-22",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "87291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lle171945@directwellstar.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1000 Corporate Center Dr Ste 200",
            "city": "Morrow",
            "state": "GA",
            "country_code": "US",
            "postal_code": "302604129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Morrow, GA

Sources for this page

Verify at the official NPI Registry.