Organization Active NPI

Healthspring Pediatrics LLC

  • Pediatrics Physician
  • Gaithersburg, MD
National Provider Identifier
1093857856
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D60583 Issued in MD
Legal business name
HEALTHSPRING PEDIATRICS LLC
Practice address
9013 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone
(301) 977-0082
Fax
(301) 977-0084
NPI assigned
Feb 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jacqueline Le, M.D.NPI 1447319637
Title
Ceo
Phone
(301) 977-0082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X D60583 MD Primary

Addresses

Primary practice location

9013 Shady Grove CT
Gaithersburg, MD 20877-1301

Mailing address

9013 Shady Grove CT
Gaithersburg, MD 20877-1301
Phone (301) 977-0082

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D1022939Healthspring Pediatrics9013 Shady Grove Court, Gaithersburg, MD 20877Certificate of waiverMar 3, 2028

National Provider Directory

National Provider Directory

Locations

9013 Shady Grove Ct
Gaithersburg, MD 20877
Phone (301) 977-0082

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093857856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9013 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771301",
            "telephone_number": "301-977-0082",
            "fax_number": "301-977-0084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9013 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771301",
            "telephone_number": "301-977-0082",
            "fax_number": "301-977-0084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSPRING PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-977-0082",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D60583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.