Organization Active NPI

Legion Medical PA

  • Psychiatry Physician
  • Austin, TX
National Provider Identifier
1104511039
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
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

Updated by the provider on May 26, 2026

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)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WP0808X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X
Psychiatric/Mental Health Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 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 Former legal business name

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.