Individual provider Active NPI

Gabrielle Irene Le Sage, CPNP

  • Pediatric Nurse Practitioner
  • Fredericksburg, VA
National Provider Identifier
1962844969
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
0024170819 Issued in VA
Practice address
4550 Empire CT
Fredericksburg, VA 22408-1939
Phone
(540) 361-1800
Fax
(540) 361-1803
NPI assigned
Jul 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 0024170819 VA Primary
Pediatric Nurse Practitioner 363LP0200X 662197 TX

Addresses

Primary practice location

4550 Empire CT
Fredericksburg, VA 22408-1939

Mailing address

4550 Empire CT
Fredericksburg, VA 22408-1939
Phone (540) 361-1800

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
Certified Pediatric Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
662197TXMDPediatric Nurse Practitioner
0024170819VAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
PL Physicians, Inc. PastSince Apr 2, 2012 Accepting new patients
PL Pediatrics, PLLC PastSince Sep 13, 2014 Accepting new patients

Organizations & group practices 2

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": "1374192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1962844969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 EMPIRE CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224081939",
            "telephone_number": "540-361-1800",
            "fax_number": "540-361-1803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 EMPIRE CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224081939",
            "telephone_number": "540-361-1800",
            "fax_number": "540-361-1803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE SAGE",
        "first_name": "GABRIELLE",
        "middle_name": "IRENE",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-19",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "VA",
            "license": "0024170819",
            "primary": true
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "662197",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2013; 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.