Individual provider Active NPI

Xuyen Kim Le, RPH

  • Pharmacist
  • Acworth, GA
National Provider Identifier
1679871503
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
RPH019617 Issued in GA
Practice address
3245 Cobb Pkwy NW
Acworth, GA 30101-3938
Phone
(770) 974-0936
Fax
(770) 529-0711
NPI assigned
Mar 1, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH019617 GA Primary

Addresses

Primary practice location

3245 Cobb Pkwy NW
Acworth, GA 30101-3938

Mailing address

1800 Mountain Lake Dr NW
Kennesaw, GA 30152-7721
Phone (678) 427-5692

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)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
RPH019617GAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1298937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1679871503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 MOUNTAIN LAKE DR NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301527721",
            "telephone_number": "678-427-5692",
            "fax_number": "770-529-0711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 COBB PKWY NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301013938",
            "telephone_number": "770-974-0936",
            "fax_number": "770-529-0711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "XUYEN",
        "middle_name": "KIM",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-01",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "RPH019617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2011; 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.