Legacy Physiatry Group Louisiana, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

LEGACY PHYSIATRY GROUP LOUISIANA, LLC

Practice address

301 Main St
Ste 2200
Baton Rouge, LA 70801-1919

Phone

(225) 224-6426

NPI assigned

Apr 13, 2015

Organization subpart

Yes

Parent organization

LEGACY PHYSIATRY GROUP, LLCAs reported in NPPES

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

Authorized official

Name

Dr. Vivek Sastry, DO

Title

President/Ceo

Phone

(972) 372-1663

Specialties & licenses 4

Addresses

Other names 1

• Legacy Physiatry Group Doing business as

Part of

Legacy Physicians Group LLC

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

{
    "created_epoch": "1428883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1144616558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 CENTRAL PKWY E",
            "address_2": "SUITE 275",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750745561",
            "telephone_number": "972-372-1663",
            "fax_number": "972-372-1657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MAIN ST",
            "address_2": "STE 2200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708011919",
            "telephone_number": "225-224-6426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PHYSIATRY GROUP LOUISIANA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEGACY PHYSIATRY GROUP, LLC",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "SASTRY",
        "authorized_official_first_name": "VIVEK",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "972-372-1663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Physiatry Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Zakeeya Perkins Lee, LPC
• Matthew Steven Leftwich, DDS
• Legacy Behavioral Health
• Legacy Care Coaches Agency
• Legacy Medical Transportation
• Legacy Recovery
• Ashante Legard
• Joi Ashley Legard, CSW
• Lawrence Legard III
• Lisa Legaux

• Physical Medicine & Rehabilitation Physician in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physical Medicine & Rehabilitation Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.