NPIMap

Organization Active NPI

Legacy Community Health Services, Inc

  • Federally Qualified Health Center (FQHC)
  • Beaumont, TX
National Provider Identifier
1063750669
Registry record updated Jan 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
H80CS07502 HRSA ID Issued in TX
Legal business name
LEGACY COMMUNITY HEALTH SERVICES, INC
Practice address
2965 Harrison St Ste 320
Beaumont, TX 77702-1150
Phone
(409) 899-1360
Fax
(713) 523-4897
NPI assigned
Jan 17, 2013
Last updated
Jan 17, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2013

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

Authorized official

Name
Katherine Caldwell
Title
Executive Director
Phone
83254855051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X H80CS07502 HRSA ID TX Primary

Addresses

Primary practice location

2965 Harrison St Ste 320
Beaumont, TX 77702-1150

Mailing address

PO Box 66308
Houston, TX 77266-6308
Phone (832) 548-5076

Other identifiers 1

IdentifierTypeStateIssuer
080462703MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Legacy Community Healthclosed77 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 15

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 15

Locations

2965 Harrison Ave
Ste 320
Beaumont, TX 77702
Phone (409) 899-1360

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1358380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358380800000",
    "number": "1063750669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 66308",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772666308",
            "telephone_number": "832-548-5076",
            "fax_number": "713-523-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2965 HARRISON ST STE 320",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777021150",
            "telephone_number": "409-899-1360",
            "fax_number": "713-523-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY COMMUNITY HEALTH SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-17",
        "last_updated": "2013-01-17",
        "status": "A",
        "authorized_official_last_name": "CALDWELL",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "83254855051"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "TX",
            "license": "H80CS07502 HRSA ID",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080462703",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.