Active NPI
Legacy Healthcare Center LLC
- Family Nurse Practitioner
- Gainesville, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- LEGACY HEALTHCARE CENTER LLC
- Practice address
- 3620 NW 43Rd St Ste a-C
Gainesville, FL 32606-8103 - Phone
- (325) 575-9991
- Fax
- (601) 429-9159
- NPI assigned
- Oct 18, 2021
- Last updated
- Feb 10, 2022
- 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
- Valorea Williams
- Title
- Aprn
- Phone
- (352) 256-5933
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
3620 NW 43Rd St Ste a-C
Gainesville, FL 32606-8103
Mailing address
113 Woodland LN
Hawthorne, FL 32640-6343
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Phone |
National Provider Directory
National Provider DirectoryLocations
1731 NW 6th St
Ste D1
Gainesville, FL 32609
Phone (352) 575-9991
3620 NW 43rd St
Ste Ac
Gainesville, FL 32606
Phone (325) 575-9991
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Family Nurse Practitioner
- Gainesville, FL
- NPI 1649371527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1644451200000",
"number": "1194488973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "113 WOODLAND LN",
"city": "HAWTHORNE",
"state": "FL",
"postal_code": "326406343"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3620 NW 43RD ST STE A-C",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326068103",
"telephone_number": "325-575-9991",
"fax_number": "601-429-9159"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGACY HEALTHCARE CENTER LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-10-18",
"last_updated": "2022-02-10",
"certification_date": "2022-02-10",
"status": "A",
"authorized_official_last_name": "WILLIAMS",
"authorized_official_first_name": "VALOREA",
"authorized_official_title_or_position": "APRN",
"authorized_official_telephone_number": "352-256-5933"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Phone",
"affiliation": "N",
"endpointDescription": "Business cell phone",
"address_1": "3620 NW 43rd St Ste A-C",
"city": "Gainesville",
"state": "FL",
"country_code": "US",
"postal_code": "326068103",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Gainesville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.