Individual provider Active NPI

David James Le

  • Family Nurse Practitioner
  • Saint Louis, MO
National Provider Identifier
1902566458
Registry record updated Jan 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2021050226 Issued in MO
Practice address
4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone
(314) 353-5190
NPI assigned
Dec 25, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2021050226 MO Primary

Addresses

Primary practice location

4352 Manchester Ave
Saint Louis, MO 63110-2138

Mailing address

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone (314) 353-5190

Other practice location 1

1055 Bowles Ave Ste 200
Fenton, MO 63026-2308
Phone (636) 496-3900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220309002843 IL Practitioner - Nurse Practitioner 7315332343 Reassigns benefits to 5 organizations
I20230317001406 MO Practitioner - Nurse Practitioner 7315332343 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Health CentersGroup PAC ID 7911815097, 53 clinicians

Practice addresses (Care Compare)

401 Holly Hills Ave
Saint Louis, MO 63111-2410
Phone 31448116151306

4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone 31448116151306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2021050226MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Belleville Urgent Care Walk-in Clinic CurrentSince Feb 16, 2022 Accepting new patients
Family Care Health Centers CurrentSince Nov 18, 2025 Accepting new patients
Alton Urgent Care Walk in Clinic Company CurrentSince Feb 16, 2022 Accepting new patients
Waterloo Urgent Care Walk in Clinic Company CurrentSince Feb 16, 2022 Accepting new patients
Wood River Urgent Care and Walk in Clinic Inc CurrentSince Jul 1, 2022 Accepting new patients
Granite City Urgent Care Walk-in Clinic CurrentSince Feb 16, 2022 Accepting new patients

Locations

1417 Washington Ave
Alton, IL 62002
Phone (618) 260-0320

2801 W Main St
Belleville, IL 62226
Phone (618) 234-3053

2861 Madison Ave
Granite City, IL 62040
Phone (618) 709-7723

907 N Illinois Route 3
Waterloo, IL 62298
Phone (618) 350-0200

211 Madison Ave
Wood River, IL 62095
Phone (618) 709-7723

14671 Telegraph Rd
Redford, MI 48239
Phone (313) 387-2100

4352 Manchester Ave
Saint Louis, MO 63110
Phone (314) 371-0336

401 Holly Hills Ave
Saint Louis, MO 63111
Phone (314) 353-5190

Organizations & group practices 7

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": "1640390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705017600000",
    "number": "1902566458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-353-5190",
            "fax_number": "314-353-7631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4352 MANCHESTER AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631102138",
            "telephone_number": "314-353-5190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 Bowles Ave Ste 200",
            "address_purpose": "LOCATION",
            "city": "Fenton",
            "state": "MO",
            "postal_code": "630262308",
            "country_code": "US",
            "telephone_number": "636-496-3900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LE",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-12-25",
        "last_updated": "2024-01-12",
        "certification_date": "2024-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2021050226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.