Active NPI
Clement Phuong Nguyen Le Thanh
- Pediatrics Physician
- Port Orchard, WA
National Provider Identifier
1386749281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00046845
- Practice address
- 320 S Kitsap Blvd
Port Orchard, WA 98366 - Phone
- (360) 876-7215
- NPI assigned
- Sep 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD00046845 | WA | Primary |
Addresses
Primary practice location
320 S Kitsap Blvd
Port Orchard, WA 98366
Mailing address
PO Box 960
400 Warren Ave Ste 300
Bremerton, WA 98337
Phone (360) 475-3709
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8465742 | Medicaid | WA |
Other names 1
- Clement Thanh Le
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peninsula Community Health Services | Past | Accepting new patients | |
| Peninsula Community Health Services | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- clement.lethanh.1@13902.direct.athenahealth.com
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Port Orchard, WA
- NPI 1205886934
Pediatrics
-
- Dentist
- Port Orchard, WA
- NPI 1588041701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203465600000",
"number": "1386749281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 960",
"address_2": "400 WARREN AVE STE 300",
"city": "BREMERTON",
"state": "WA",
"postal_code": "98337",
"telephone_number": "360-475-3709",
"fax_number": "360-373-2096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 S KITSAP BLVD",
"city": "PORT ORCHARD",
"state": "WA",
"postal_code": "98366",
"telephone_number": "360-876-7215"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE THANH",
"first_name": "CLEMENT",
"middle_name": "PHUONG NGUYEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-14",
"last_updated": "2008-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00046845",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8465742",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CLEMENT",
"last_name": "LE",
"middle_name": "THANH",
"credential": "MD",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Port Orchard, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.