Individual provider Active NPI

Thanhtam Thi Le, MD

  • Pediatrics Physician
  • Woodstock, GA
National Provider Identifier
1306191721
Registry record updated Jan 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
074941 Issued in GA
Practice address
2000 Professional Way Ste 200
Woodstock, GA 30188-4093
Phone
(770) 517-0250
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 074941 GA Primary

Addresses

Primary practice location

2000 Professional Way Ste 200
Woodstock, GA 30188-4093

Mailing address

2000 Professional Way Ste 200
Woodstock, GA 30188-4093
Phone (770) 517-0250

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
074941GAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodstock Pediatric Medicine Pediatrics Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514764800000",
    "number": "1306191721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 PROFESSIONAL WAY STE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884093",
            "telephone_number": "770-517-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 PROFESSIONAL WAY STE 200",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301884093",
            "telephone_number": "770-517-0250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "THANHTAM",
        "middle_name": "THI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2018-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "074941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2018; 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.