Active NPI
Legacy Healthcare Services, Inc.
- Physical Therapist
- Durham, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- LEGACY HEALTHCARE SERVICES, INC.
- Practice address
- 2701 Pickett Rd
Durham, NC 27705-5688 - Phone
- (919) 424-5080
- Fax
- (919) 431-9224
- NPI assigned
- Jun 30, 2005
- Last updated
- Dec 6, 2024
- 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
- Mr. William Gil Wilson Jr.
- Title
- Chief Financial Officer
- Phone
- (919) 424-5080
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X | |||
| Speech-Language Pathologist | 235Z00000X |
Addresses
Primary practice location
2701 Pickett Rd
Durham, NC 27705-5688
Mailing address
110 Horizon Dr Ste 310
Raleigh, NC 27615-4926
Phone (919) 424-5080
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040105000035 | NC | Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services | 2163339722 | Practice locations: Raleigh, NC; Greensboro, NC; Morrisville, NC; High Point, NC; Roxboro, NC; Wake Forest, NC; Wilmington, NC; Winston Salem, NC… |
| O20170118000750 | NC | Part B Supplier - Physical/Occupational Therapy Group in Private Practice | 2163339722 | Receives reassigned benefits from 306 practitioners |
National Provider Directory
National Provider DirectoryLocations
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Phone 5122436556737
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Concord, NC 28027
5705 Fayetteville Rd
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Phone (919) 401-0100
10810 Sandy Oak Ln
Ste 210
Raleigh, NC 27614
12800 Spruce Tree Way
Apt 210
Raleigh, NC 27614
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Raleigh, NC 27615
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Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Windsor Point Inc CCRC | Skilled nursing facility | Adp of the SNF | Jul 1, 2011 |
Practitioners & affiliated clinicians
Practitioners 334
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.
-
- Physical Therapist
- Asheville, NC
- NPI 1003401159
-
- Occupational Therapist
- Siler City, NC
- NPI 1558606194
-
- Occupational Therapist
- Chapel Hill, NC
- NPI 1487276051
-
- Speech-Language Pathologist
- Raleigh, NC
- NPI 1528827474
-
- Speech-Language Pathologist
- Southern Pines, NC
- NPI 1407749443
-
- Occupational Therapist
- Raeford, NC
- NPI 1275359804
-
- Physical Therapist
- Durham, NC
- NPI 1811779846
-
- Physical Therapist
- Waynesville, NC
- NPI 1326446733
-
- Occupational Therapist
- Raleigh, NC
- NPI 1164795100
-
- Physical Therapist
- Fayetteville, NC
- NPI 1841748407
-
- Physical Therapist
- Cary, NC
- NPI 1801205117
-
- Physical Therapist
- Cary, NC
- NPI 1164946323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120089600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1733443200000",
"number": "1104823400",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 HORIZON DR STE 310",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276154926",
"telephone_number": "919-424-5080",
"fax_number": "919-431-9224"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 PICKETT RD",
"city": "DURHAM",
"state": "NC",
"postal_code": "277055688",
"telephone_number": "919-424-5080",
"fax_number": "919-431-9224"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY HEALTHCARE SERVICES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-30",
"last_updated": "2024-12-06",
"certification_date": "2024-12-06",
"status": "A",
"authorized_official_last_name": "WILSON",
"authorized_official_first_name": "WILLIAM",
"authorized_official_middle_name": "GIL",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "919-424-5080",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Jr."
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
},
{
"code": "235Z00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Speech-Language Pathologist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.