Physician Compare National (NPI:1568493062)

HEALTHCARE PROVIDER: SON DIEP LE MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1568493062
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	5496737306
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100830000105
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LE
	Individual professional last name
Provider First Name	SON
	Individual professional first name
Provider Middle Name	D.
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	CHICAGO COLLEGE OF MEDICINE AND SURGERY
	Individual professional's medical school
Graduation Year	1995
	Individual professional's medical school graduation year
Primary Specialty	PHYSICAL MEDICINE AND REHABILITATION
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	CENTER FOR SPINE JOINT AND NEUROMUSCULAR REHAB PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	1759363658
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	5651 FRIST BLVD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 712
	Group Practice or individual's line 2 address
City	HERMITAGE
	Group Practice or individual's city
State	TN
	Group Practice or individual's state
Zip Code	370762061
	Group Practice or individual's zip code (9 digits when available)
Phone Number	6158729966
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	440150
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	TRISTAR SUMMIT MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Professional Accepts Medicare Assignment	Y