Active NPI
Sandra Marks Legette, P.T.
- Physical Therapist
- Washington, GA
National Provider Identifier
1235249293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 000952
- Practice address
- 200 Upton Mill Dr
Washington, GA 30673-4015 - Phone
- (706) 678-4531
- Fax
- (706) 678-3285
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 000952 | GA | Primary |
Addresses
Primary practice location
200 Upton Mill Dr
Washington, GA 30673-4015
Mailing address
200 Upton Mill Dr
Washington, GA 30673-4015
Phone (706) 678-4531
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2346242 | Medicaid | GA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000952 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235249293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "200 UPTON MILL DR",
"city": "WASHINGTON",
"state": "GA",
"postal_code": "306734015",
"telephone_number": "706-678-4531",
"fax_number": "706-678-3285"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 UPTON MILL DR",
"city": "WASHINGTON",
"state": "GA",
"postal_code": "306734015",
"telephone_number": "706-678-4531",
"fax_number": "706-678-3285"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGETTE",
"first_name": "SANDRA",
"middle_name": "MARKS",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "000952",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2346242",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Washington, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.