Active NPI
David Van Le, PT, DPT
- Physical Therapist
- Grayson, GA
National Provider Identifier
1598433252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT015762
- Practice address
- 2065 Grayson Hwy Ste B
Grayson, GA 30017-1766 - Phone
- (678) 376-0213
- NPI assigned
- Aug 30, 2021
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305214664 | VA | |
| Physical Therapist | 225100000X | PT015762 | GA | Primary |
Addresses
Primary practice location
2065 Grayson Hwy Ste B
Grayson, GA 30017-1766
Mailing address
6397 Lee Hwy
Chattanooga, TN 37421-2564
Phone (423) 238-3473
Other practice location 1
12825 Minnieville Rd Ste 201
Lake Ridge, VA 22192-3602
Phone (703) 647-3130
Other practice location 2
4825 Sugarloaf Pkwy Ste C
Lawrenceville, GA 30044-8800
Phone (678) 985-0238
Other practice location 3
47 Postal Pkwy
Newnan, GA 30263-2885
Phone (770) 632-6800
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2305214664 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644364800000",
"number": "1598433252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6397 LEE HWY",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374212564",
"telephone_number": "423-238-3473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2065 GRAYSON HWY STE B",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300171766",
"telephone_number": "678-376-0213"
}
],
"practiceLocations": [
{
"address_1": "12825 Minnieville Rd Ste 201",
"address_purpose": "LOCATION",
"city": "Lake Ridge",
"state": "VA",
"postal_code": "221923602",
"country_code": "US",
"telephone_number": "703-647-3130",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4825 Sugarloaf Pkwy Ste C",
"address_purpose": "LOCATION",
"city": "Lawrenceville",
"state": "GA",
"postal_code": "300448800",
"country_code": "US",
"telephone_number": "678-985-0238",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "47 Postal Pkwy",
"address_purpose": "LOCATION",
"city": "Newnan",
"state": "GA",
"postal_code": "302632885",
"country_code": "US",
"telephone_number": "770-632-6800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LE",
"first_name": "DAVID",
"middle_name": "VAN",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-30",
"last_updated": "2022-02-09",
"certification_date": "2022-02-09",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305214664",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT015762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grayson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.