Active NPI
An-Phuong Thuy Le, M.D.
- Pediatrics Physician
- Douglasville, GA
National Provider Identifier
1902068109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 74874
- Practice address
- 6095 Professional Pkwy Ste 100
Douglasville, GA 30134-5607 - Phone
- (770) 920-2255
- NPI assigned
- Jun 28, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 237397 | MA | |
| Pediatrics Physician | 208000000X | 74874 | GA | Primary |
Addresses
Primary practice location
6095 Professional Pkwy Ste 100
Douglasville, GA 30134-5607
Mailing address
6095 Professional Pkwy Ste 100
Douglasville, GA 30134-5607
Phone (770) 920-2255
Other practice location 1
1353 Dorchester Ave
Dorchester, MA 02122
Phone (617) 288-3230
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 74874 | GA | MD | Pediatrics Physician |
| 237397 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1902068109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6095 PROFESSIONAL PKWY STE 100",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345607",
"telephone_number": "770-920-2255"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6095 PROFESSIONAL PKWY STE 100",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301345607",
"telephone_number": "770-920-2255"
}
],
"practiceLocations": [
{
"address_1": "1353 Dorchester Ave",
"address_purpose": "LOCATION",
"city": "Dorchester",
"state": "MA",
"postal_code": "02122",
"country_code": "US",
"telephone_number": "617-288-3230",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "LE",
"first_name": "AN-PHUONG",
"middle_name": "THUY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-28",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "237397",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": "GA",
"license": "74874",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.