NPIMap

Organization Active NPI

Legacy Healthcare Services Inc

  • Physical Therapist
  • West Chester, OH
National Provider Identifier
1174153266
Registry record updated Dec 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LEGACY HEALTHCARE SERVICES INC
Practice address
7047 Hamilton Mason Rd
West Chester, OH 45069-1424
Phone
(855) 239-3467
NPI assigned
Jan 17, 2020
Last updated
Dec 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 6, 2024

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

Authorized official

Name
William G Wilson Jr.
Title
Chief Financial Officer
Phone
(919) 424-5080

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU

Addresses

Primary practice location

7047 Hamilton Mason Rd
West Chester, OH 45069-1424

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 OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200304001327 OH Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2163339722 Receives reassigned benefits from 171 practitioners
Practice locations: Parma, OH; Hudson, OH; Independence, OH; Madison, OH; Mason, OH; Mayfield Heights, OH; Mentor, OH; Miamisburg, OH…

National Provider Directory

National Provider Directory

Locations

3927 38th St NW
Canton, OH 44718
Phone (330) 493-0096

5277 Chillicothe Rd
Chagrin Falls, OH 44022
Phone (440) 557-1186

8100 Washington St
Chagrin Falls, OH 44023
Phone (440) 384-3358

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.

FacilityTypeRoleSince
Windsor Point Inc CCRCFuquay-Varina, NC, CCN 345500 Skilled nursing facility Adp of the SNF Jul 1, 2011

Practitioners & affiliated clinicians

Practitioners 176

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.

View all 176

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1174153266",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7047 HAMILTON MASON RD",
            "city": "WEST CHESTER",
            "state": "OH",
            "postal_code": "450691424",
            "telephone_number": "855-239-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "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": "G",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "919-424-5080",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, OH

Sources for this page

Verify at the official NPI Registry.