Active NPI
Phat V Le, AA
- Anesthesiologist Assistant
- Raleigh, NC
National Provider Identifier
1437408531
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiologist Assistant
- License
- 2012028965
- Practice address
- 3400 Wake Forest Rd
Raleigh, NC 27609-7317 - Phone
- (919) 954-3000
- NPI assigned
- Sep 5, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Anesthesiologist Assistant | 367H00000X | 2012028965 | MO | Primary |
Addresses
Primary practice location
3400 Wake Forest Rd
Raleigh, NC 27609-7317
Mailing address
3100 Spring Forest Rd Ste 130
Raleigh, NC 27616-2880
Phone (919) 873-9533
Other practice location 1
1235 E Cherokee
Springfield, MO 65804-2203
Phone (417) 820-2829
Other practice location 2
1235 E Cherokee
Springfield, MO 65804-2203
Phone (417) 820-2829
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437408531 | Medicaid | MO | |
| 431560263 | Other | MO | TRICARE |
| P01129107 | Other | MO | RR MCR |
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
- Associate of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012028965 | MO | MD | Anesthesiologist Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346803200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1437408531",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3100 SPRING FOREST RD STE 130",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276162880",
"telephone_number": "919-873-9533",
"fax_number": "844-454-0171"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 WAKE FOREST RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276097317",
"telephone_number": "919-954-3000"
}
],
"practiceLocations": [
{
"address_1": "1235 E Cherokee",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "MO",
"postal_code": "658042203",
"country_code": "US",
"telephone_number": "417-820-2829",
"fax_number": "417-820-8852",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1235 E Cherokee",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "MO",
"postal_code": "658042203",
"country_code": "US",
"telephone_number": "417-820-2829",
"fax_number": "417-820-8852",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LE",
"first_name": "PHAT",
"middle_name": "V",
"credential": "AA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-09-05",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "367H00000X",
"taxonomy_group": "",
"desc": "Anesthesiologist Assistant",
"state": "MO",
"license": "2012028965",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437408531",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "431560263",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MCR",
"identifier": "P01129107",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 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.