Organization Active NPI

Annandale OB GYN

  • Specialist
  • Annandale, VA
National Provider Identifier
1811057102
Registry record updated Jul 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
ANNANDALE OB GYN
Practice address
4208 Evergreen LN
Ste 213
Annandale, VA 22003-3235
Phone
(703) 642-7522
NPI assigned
Dec 9, 2006
Last updated
Jul 1, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2008

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

Authorized official

Name
Dr. Anna Nha-Khanh Le, MDNPI 1841382553
Title
Director
Phone
(703) 642-7522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X VA Primary

Addresses

Primary practice location

4208 Evergreen LN
Ste 213
Annandale, VA 22003-3235

Mailing address

PO Box 3028
Merrifield, VA 22116-3028
Phone (703) 642-7522

Other identifiers 1

IdentifierTypeStateIssuer
010179785MedicaidVA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
49D2151130Annandale OB/GYN4208 Evergreen LN #213, Annandale, VA 22003Certificate of waiverJul 11, 2028

National Provider Directory

National Provider Directory

Locations

5148 Leesburg Pike
Alexandria, VA 22302

4208 Evergreen Ln
Annandale, VA 22003
Phone (703) 642-2288

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165622400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214870400000",
    "number": "1811057102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3028",
            "city": "MERRIFIELD",
            "state": "VA",
            "postal_code": "221163028",
            "telephone_number": "703-642-7522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4208 EVERGREEN LN",
            "address_2": "STE 213",
            "city": "ANNANDALE",
            "state": "VA",
            "postal_code": "220033235",
            "telephone_number": "703-642-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNANDALE OB GYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-09",
        "last_updated": "2008-07-01",
        "status": "A",
        "authorized_official_last_name": "LE",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "NHA-KHANH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "703-642-7522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010179785",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annandale, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.