Olivia Le

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024182153 Issued in VA

Practice address

3903 Fair Ridge Dr Ste 209
Fairfax, VA 22033-2944

Phone

(703) 424-9676

NPI assigned

Dec 16, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Shady Grove Fertility Reproductive Science Center

  • Reproductive Endocrinology Physician
  • Rockville, MD
  • NPI 1891849832

  Single Specialty

  NPD (past)
• Shady Grove Reproductive Science Center PC

  • Ambulatory Surgical Clinic/Center
  • Rockville, MD
  • NPI 1437232758
  NPD (past)

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649289600000",
    "number": "1669131645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14276 LADDERBACKED DR",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "201555919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3903 FAIR RIDGE DR STE 209",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220332944",
            "telephone_number": "703-424-9676"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14276 Ladderbacked Dr",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "VA",
            "postal_code": "201555919",
            "country_code": "US",
            "telephone_number": "703-981-3584",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "OLIVIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2022-04-07",
        "certification_date": "2022-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083B0002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "VA",
            "license": "0024182153",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024182153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "NA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jimmy Le
• Kathy L Le, DDS
• Melissa Le, MD
• Michael Tam Le
• Michelle Thuy Le
• Thi Ngoc Oanh Le
• Thienquang Dat Le, M.D.
• Thoa D Le, PHARM.D.
• Tim Huynh Le
• Trina Minhthi Le

• Family Nurse Practitioner in Fairfax, VA
• Providers in Fairfax, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 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.

Verify at the official NPI Registry.