Individual provider Active NPI

Anthony Orlando Le, DC

  • Chiropractor
  • Bentonville, AR
National Provider Identifier
1700350378
Registry record updated Jan 17, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16209 Issued in AR
Practice address
1706 SE Walton Blvd Ste 6
Bentonville, AR 72712-3201
Phone
(479) 464-4413
Fax
(479) 464-4430
NPI assigned
Jan 17, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16209 AR Primary

Addresses

Primary practice location

1706 SE Walton Blvd Ste 6
Bentonville, AR 72712-3201

Mailing address

1706 SE Walton Blvd Ste 6
Bentonville, AR 72712-3201
Phone (479) 464-4413

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230207001533 AR Practitioner - Chiropractic 6709258494 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

246 S Maestri Rd
Suite 4
Tontitown, AR 72762-9703
Phone (479) 751-2322

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16209ARMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Buena Vida Chiropractic LLC Chiropractor CurrentSince Dec 1, 2022 Accepting new patients
Santos Chiropractic PLLC Chiropractor Current Accepting new patients
Northwest Arkansas Functional Health LLC CurrentSince Dec 1, 2022 Accepting new patients
Santos Chiropractic, PLLC Chiropractor PastSince Feb 25, 2010 Accepting new patients

Locations

1706 SE Walton Blvd
Ste 6
Bentonville, AR 72712
Phone (479) 464-4413

246 S Maestri Rd
Ste 4
Tontitown, AR 72762
Phone (479) 220-9909

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1547683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1700350378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 SE WALTON BLVD STE 6",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123201",
            "telephone_number": "479-464-4413",
            "fax_number": "479-464-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 SE WALTON BLVD STE 6",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123201",
            "telephone_number": "479-464-4413",
            "fax_number": "479-464-4430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "ANTHONY",
        "middle_name": "ORLANDO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-17",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AR",
            "license": "16209",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.