I Am Legacy Ptca Inc.

Primary specialty

Voluntary or Charitable AgencyTaxonomy code 251V00000X

Legal business name

I AM LEGACY PTCA INC.

Practice address

514 W Oglethorpe Blvd
Albany, GA 31701-1478

Phone

(404) 465-1391

NPI assigned

Nov 12, 2024

Organization subpart

No

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

Authorized official

Name

Evangela Childs

Title

Executive Director

Phone

(404) 465-1391

Specialties & licenses 6

Addresses

Locations

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

{
    "created_epoch": "1731369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731369600000",
    "number": "1003630427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W OGLETHORPE BLVD STE G",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011479",
            "telephone_number": "404-465-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 W OGLETHORPE BLVD",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317011478",
            "telephone_number": "404-465-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "I AM LEGACY PTCA INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-12",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A",
        "authorized_official_last_name": "CHILDS",
        "authorized_official_first_name": "EVANGELA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "404-465-1391"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251J00000X",
            "taxonomy_group": "",
            "desc": "Nursing Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251V00000X",
            "taxonomy_group": "",
            "desc": "Voluntary or Charitable",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candice Leggett Hunter
• Patricia Hunter, RN
• Robin Hussion-Dale, PMHNP-BC
• Elizabeth Ashley Hutchins, PHARMD
• Thanh Cong Huynh, MD
• Charmaine Idlett, RDH
• Mark E Ignatz, M.D.
• Ik Medical Diagnostic Services
• Margarita Ilecki, M.S.
• Michael Im, M.D.

• Voluntary or Charitable Agency in Albany, GA
• Providers in Albany, GA by specialty
• Voluntary or Charitable Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.