Individual provider Active NPI

Elizabeth Kim Le, RDMS

  • Diagnostic Ultrasound Physician
  • Doraville, GA
National Provider Identifier
1205515954
Registry record updated Jan 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Ultrasound PhysicianTaxonomy code 2085U0001X
License
169738 Issued in GA
Practice address
6035 Peachtree Rd Ste C218
Doraville, GA 30360-3240
Phone
(678) 833-2433
Fax
(678) 607-9301
NPI assigned
Jul 11, 2023
Last updated
Jan 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 11, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physiological Laboratory 293D00000X 169738 GA
Diagnostic Ultrasound Physician 2085U0001X 169738 GA Primary

Addresses

Primary practice location

6035 Peachtree Rd Ste C218
Doraville, GA 30360-3240

Mailing address

6035 Peachtree Rd Ste C218
Doraville, GA 30360-3240
Phone (678) 833-2433

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
169738GAMDPhysiological Laboratory

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Ultrasound Imaging I LLC Physiological Laboratory CurrentSince Oct 1, 2023 Accepting new patients

Locations

6035 Peachtree Rd
Ste C218
Doraville, GA 30360
Phone (678) 833-2433

Organizations & group practices 1

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": "1689033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704931200000",
    "number": "1205515954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6035 PEACHTREE RD STE C218",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303603240",
            "telephone_number": "678-833-2433",
            "fax_number": "678-607-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6035 PEACHTREE RD STE C218",
            "city": "DORAVILLE",
            "state": "GA",
            "postal_code": "303603240",
            "telephone_number": "678-833-2433",
            "fax_number": "678-607-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "ELIZABETH",
        "middle_name": "KIM",
        "credential": "RDMS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-11",
        "last_updated": "2024-01-11",
        "certification_date": "2023-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "GA",
            "license": "169738",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "GA",
            "license": "169738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doraville, GA

Sources for this page

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

Verify at the official NPI Registry.