Active NPI
Kimberly Duy Le, OD
- Optometrist
- Henderson, NV
National Provider Identifier
1629635636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1019
- Practice address
- 300 E Lake Mead Pkwy
Henderson, NV 89015-5576 - Phone
- (858) 348-7790
- NPI assigned
- May 24, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0NEWGRAD | CA | |
| Optometrist | 152W00000X | 1019 | NV | Primary |
Addresses
Primary practice location
300 E Lake Mead Pkwy
Henderson, NV 89015-5576
Mailing address
8701 Red Brook Dr
Unit 204
Las Vegas, NV 89128-8455
Phone (858) 348-7790
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 |
|---|---|---|---|
| 0NEWGRAD | CA | MD | Optometrist |
| 1019 | NV | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1558656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1603238400000",
"number": "1629635636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8701 RED BROOK DR",
"address_2": "UNIT 204",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891288455",
"telephone_number": "858-348-7790"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 E LAKE MEAD PKWY",
"city": "HENDERSON",
"state": "NV",
"postal_code": "890155576",
"telephone_number": "858-348-7790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LE",
"first_name": "KIMBERLY",
"middle_name": "DUY",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-05-24",
"last_updated": "2020-10-21",
"certification_date": "2020-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "0NEWGRAD",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "NV",
"license": "1019",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Henderson, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.