Active NPI
Connie D. Le, M.D, P.C
- Exclusive Provider Organization
- Annandale, VA
National Provider Identifier
1174712301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Exclusive Provider Organization
- License
- 0101237697
- Legal business name
- CONNIE D. LE, M.D, P.C
- Practice address
- 4208 Evergreen LN
Suite 214
Annandale, VA 22003-3235 - Phone
- (703) 642-6633
- Fax
- (703) 642-6699
- NPI assigned
- Oct 24, 2007
- Last updated
- Oct 24, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Connie D Le, M.D.
- Title
- President
- Phone
- (703) 642-6633
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Exclusive Provider Organization | 302F00000X | 0101237697 | VA | Primary |
Addresses
Primary practice location
4208 Evergreen LN
Suite 214
Annandale, VA 22003-3235
Mailing address
4208 Evergreen LN
Suite 214
Annandale, VA 22003-3235
Phone (703) 642-6633
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 178649 | Other | VA | UNICARE |
| 2536483 | Other | VA | UNITED HEALTH CARE |
| 9166111 | Other | VA | CIGNA |
| K8390001 | Other | VA | BLUE CROSS BLUE SHIELD |
| 720471 | Other | VA | NCPPO, HEALTH LINK |
| 9389238 | Other | VA | PHCS |
| 178649 | Other | VA | ANTHEM |
| 7120704 | Other | VA | AETNA NON HMO |
| 3850929 | Other | VA | AETNA HMO |
| 9389238 | Other | VA | A;LIED BENEFIT SYSTEM |
| 9389238 | Other | VA | JOHN ALDEN LIFE INSURANCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4208 Evergreen Ln
Ste 214
Annandale, VA 22003
Phone (703) 459-0310
2810 Old Lee Hwy
Fairfax, VA 22031
Phone (703) 995-4970
2812 Old Lee Hwy
Ste 210A
Fairfax, VA 22031
Phone (703) 642-6633
Practitioners & affiliated clinicians
Practitioners 6
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193184000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1193184000000",
"number": "1174712301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4208 EVERGREEN LN",
"address_2": "SUITE 214",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220033235",
"telephone_number": "703-642-6633",
"fax_number": "703-642-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4208 EVERGREEN LN",
"address_2": "SUITE 214",
"city": "ANNANDALE",
"state": "VA",
"postal_code": "220033235",
"telephone_number": "703-642-6633",
"fax_number": "703-642-6699"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONNIE D. LE, M.D, P.C",
"organizational_subpart": "NO",
"enumeration_date": "2007-10-24",
"last_updated": "2007-10-24",
"status": "A",
"authorized_official_last_name": "LE",
"authorized_official_first_name": "CONNIE",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "703-642-6633",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "302F00000X",
"taxonomy_group": "",
"desc": "Exclusive Provider Organization",
"state": "VA",
"license": "0101237697",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNICARE",
"identifier": "178649",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTH CARE",
"identifier": "2536483",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "9166111",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "K8390001",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPPO, HEALTH LINK",
"identifier": "720471",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHCS",
"identifier": "9389238",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "178649",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA NON HMO",
"identifier": "7120704",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "3850929",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "A;LIED BENEFIT SYSTEM",
"identifier": "9389238",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN ALDEN LIFE INSURANCE",
"identifier": "9389238",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Annandale, VA
- Jonathan Evan Collinsworth, CMT
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- Communikids LLC
- Community Residences, Inc.
- Confident Dentistry Corporation (Total Dental Care)
- Connie D.Le, M.D., PC.
- Continental Enterprise Inc (Central Acupuncture)
- Alexandra Cooper
- Judith Ann Cornecelli, RN, LCSW,
- Devin Marie Correa, OTR/L
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; 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.