Individual provider Active NPI

Dat Thanh Le, FNP-C

  • Family Nurse Practitioner
  • Clearwater, FL
National Provider Identifier
1194397265
Registry record updated Sep 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN240213 Issued in GA
Practice address
2555 Enterprise Rd Ste 3
Clearwater, FL 33763-1104
Phone
(813) 692-6091
NPI assigned
Jul 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN240213 GA Primary
Nurse Practitioner 363L00000X 202026 ND
Family Nurse Practitioner 363LF0000X 16812 WI

Addresses

Primary practice location

2555 Enterprise Rd Ste 3
Clearwater, FL 33763-1104

Mailing address

2555 Enterprise Rd Ste 3
Clearwater, FL 33763-1104
Phone (813) 692-6091

Other practice location 1

800 Riverside Dr
Waupaca, WI 54981-1943
Phone (715) 258-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL, ND, WI4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20210928000956 GA Practitioner - Nurse Practitioner 4688071046 Reassigns benefits to 4 organizations
I20240125000834 FL Practitioner - Nurse Practitioner 4688071046
I20250520000496 ND Practitioner - Nurse Practitioner 4688071046 Reassigns benefits to 2 organizations
I20250613000519 WI Practitioner - Nurse Practitioner 4688071046 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hightower Emergency Group PCGroup PAC ID 3577825751, 29 clinicians

Practice addresses (Care Compare)

801 W Gordon St
Thomaston, GA 30286-3426
Phone (706) 647-8111

Hospital & facility affiliations

  • CHI St Alexius Health Williston Hospital, Williston, ND, CCN 351334
  • Guthrie County Hospital Hospital, Guthrie Center, IA, CCN 161314
  • Yukon Kuskokwim Delta Reg Hospital Hospital, Bethel, AK, CCN 020018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN240213GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revival Wound Specialists LLC Nurse Practitioner Current Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince May 16, 2025 Accepting new patients
Medlife Urgent Care LLC CurrentSince Aug 1, 2021 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. Nurse Practitioner CurrentSince May 16, 2025 Accepting new patients
Thedacare Medical Center - Shawano, Inc. CurrentSince May 16, 2025 Accepting new patients
Thedacare Medical Center - Waupaca, Inc. CurrentSince May 16, 2025 Accepting new patients
Richard S Veiga MD SC Current Accepting new patients
Mercy Medical Center Current Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Medlife Healthcare LLC CurrentSince Aug 1, 2021 Accepting new patients
Mercy Medical Center CurrentSince May 2, 2025 Accepting new patients
Phoebe Sumter Medical Center, Inc. CurrentSince Aug 5, 2024 Accepting new patients
Mercy Home Care CurrentSince May 2, 2025 Accepting new patients
Phoebe Sumter Medical Center, Inc CurrentSince Aug 5, 2024 Accepting new patients
Hightower Emergency Group, PC Nurse Practitioner CurrentSince Sep 28, 2025 Accepting new patients

Locations

2002 Palmyra Rd
Ste 201
Albany, GA 31701
Phone (229) 312-5802

126 US Highway 280 W
Americus, GA 31719
Phone (229) 924-6011

2129 Friendship Rd
Ste 100
Buford, GA 30519
Phone (770) 209-2787

345 Huntington Place Ct
Ste 200B
McDonough, GA 30253
Phone (678) 993-0820

5825 Buford Hwy
Ste 400
Norcross, GA 30071
Phone (678) 993-0820

5825 Buford Hwy
Ste 300
Norcross, GA 30071
Phone (678) 782-6920

801 W Gordon St
Thomaston, GA 30286
Phone (706) 647-4371

3369 Solutions Ctr
Chicago, IL 60677

1301 15th Ave W
Williston, ND 58801
Phone (701) 774-7400

1213 15th Ave W
Williston, ND 58801
Phone (701) 572-7641

3 Neenah Ctr
Neenah, WI 54956
Phone (920) 454-4229

100 Cty Road B
Shawano, WI 54166
Phone (715) 524-2161

800 Riverside Dr
Waupaca, WI 54981
Phone (715) 258-1000

Interoperability endpoints

  • Direct secure messaging: dle1178253@direct.unitypoint.org

Organizations & group practices 15

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.

View all 15

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": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1194397265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2555 ENTERPRISE RD STE 3",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631104",
            "telephone_number": "813-692-6091",
            "fax_number": "813-423-6556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 ENTERPRISE RD STE 3",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337631104",
            "telephone_number": "813-692-6091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Riverside Dr",
            "address_purpose": "LOCATION",
            "city": "Waupaca",
            "state": "WI",
            "postal_code": "549811943",
            "country_code": "US",
            "telephone_number": "715-258-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "DAT",
        "middle_name": "THANH",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-16",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN240213",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ND",
            "license": "202026",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "16812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearwater, FL

Sources for this page

Verify at the official NPI Registry.