Legent Hill Country ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

LEGENT HILL COUNTRY ASC, LLC

Doing business as

Legent Hill Country ASC

Practice address

811 S. Milam Street
Fredericksburg, TX 78624

Phone

(817) 421-1066

NPI assigned

Feb 7, 2024

Last updated

Feb 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jordan Fowler

Title

Ceo

Phone

(917) 216-6285

Specialties & licenses 1

Addresses

Other names 1

• Legent Hill Country ASC Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1225892631. Details of each certification follow.

• CCN 45C0451318 Ambulatory surgical center · Active · Name & address match · Details

Ambulatory surgical center certification: CCN 45C0451318

Legal name

Legent Hill Country ASC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Sep 12, 2025

Last certification

Aug 29, 2025

Ownership / control type

Proprietary

Facility address

811 S Milam St
Fredericksburg, TX 78624

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

• Fredericksburg Eye Associates, PLLC

  • Ophthalmology Physician
  • Fredericksburg, TX
  • NPI 1023515533

  Member Of

  NPD member
• Texas Hill Country Orthopaedics & Sports Medicine P.a.

  • Orthopaedic Surgery Physician
  • Fredericksburg, TX
  • NPI 1184889255

  Member Of

  NPD member

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

{
    "created_epoch": "1707264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1225892631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4090 MAPLESHADE LN STE 220",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750930026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 S. MILAM STREET",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "78624",
            "telephone_number": "817-421-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENT HILL COUNTRY ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-07",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-06",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "917-216-6285"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legent Hill Country ASC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Logan Laratta, PHARMD
• Charity Lawson, CNS
• Ottis L Layne Jr., MD
• Chelsey Alexis Leal, SLP
• Quynh H. Lee, LPC
• Dustin Thomas Lemley
• Erin Michelle Leshikar, AU.D.
• Debra Lewis, OTR/L
• Phillip E Lietz, R.PH.
• Amy Kathryn Lindsay, M.S.

• Ambulatory Surgical Clinic/Center in Fredericksburg, TX
• Providers in Fredericksburg, TX by specialty
• Ambulatory Surgical Clinic/Center in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.