Active NPI
Legion Medical PA
- Psychiatry Physician
- Austin, TX
National Provider Identifier
1104511039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- Legal business name
- LEGION MEDICAL PA
- Practice address
- 1606 Headway Cir Ste 9779
Austin, TX 78754-5123 - Phone
- (737) 237-2900
- Fax
- (812) 221-2017
- NPI assigned
- Apr 6, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jonathan Kole, MD
- Title
- President
- Phone
- (773) 633-3499
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | |||
| Psychiatry Physician | 2084P0800X | Primary | ||
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | |||
| Psychiatric/Mental Health Clinical Nurse Specialist | 364SP0808X |
Addresses
Primary practice location
1606 Headway Cir Ste 9779
Austin, TX 78754-5123
Mailing address
1606 Headway Cir Ste 9779
Austin, TX 78754-5123
Other practice location 1
350 E 400 S Ste 54825
Salt Lake City, UT 84111-2993
Phone (737) 237-2900
Other practice location 2
1613 Coyote Rdg
Carrollton, TX 75010-3227
Phone (737) 237-2900
Other names 1
- Legion Health PA
National Provider Directory
National Provider DirectoryLocations
1606 Headway Cir
Ste 9779
Austin, TX 78754
Phone (737) 237-2900
350 E 400 S
Ste 54825
Salt Lake City, UT 84111
Phone (737) 237-2900
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1680739200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779753600000",
"number": "1104511039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1606 HEADWAY CIR STE 9779",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787545123"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1606 HEADWAY CIR STE 9779",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787545123",
"telephone_number": "737-237-2900",
"fax_number": "812-221-2017"
}
],
"practiceLocations": [
{
"address_1": "350 E 400 S Ste 54825",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841112993",
"country_code": "US",
"telephone_number": "737-237-2900",
"fax_number": "812-221-2017",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1613 Coyote Rdg",
"address_purpose": "LOCATION",
"city": "Carrollton",
"state": "TX",
"postal_code": "750103227",
"country_code": "US",
"telephone_number": "737-237-2900",
"fax_number": "812-221-2017",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LEGION MEDICAL PA",
"organizational_subpart": "NO",
"enumeration_date": "2023-04-06",
"last_updated": "2026-05-26",
"certification_date": "2026-05-26",
"status": "A",
"authorized_official_last_name": "KOLE",
"authorized_official_first_name": "JONATHAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "773-633-3499",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "163WP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": true
},
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "364SP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Legion Health PA",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.