Individual provider Active NPI

Thy Phuong Le, PHARMD

  • Pharmacist
  • Bradenton, FL
National Provider Identifier
1861003915
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PS53906 Issued in FL
Practice address
4220 Manatee Ave W
Bradenton, FL 34205-1721
Phone
(941) 749-1561
Fax
(941) 746-1083
NPI assigned
Aug 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PS53906 FL Primary

Addresses

Primary practice location

4220 Manatee Ave W
Bradenton, FL 34205-1721

Mailing address

4220 Manatee Ave W
Bradenton, FL 34205-1721
Phone (941) 749-1561

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL n/a

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS53906FLMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597190400000",
    "number": "1861003915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4220 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342051721",
            "telephone_number": "941-749-1561",
            "fax_number": "941-746-1083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4220 MANATEE AVE W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342051721",
            "telephone_number": "941-749-1561",
            "fax_number": "941-746-1083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "THY",
        "middle_name": "PHUONG",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS53906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "n/a",
            "affiliation": "N",
            "endpointDescription": "n/a",
            "address_1": "4220 Manatee Ave W",
            "city": "Bradenton",
            "state": "FL",
            "country_code": "US",
            "postal_code": "342051721",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.