Active NPI
Jeremiah S Legg, LCSW
- Clinical Social Worker
- Meridian, ID
National Provider Identifier
1255081683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW-36137
- Practice address
- 4949 S Hillsdale Ave
Meridian, ID 83642-7586 - Phone
- (208) 706-6400
- Fax
- (208) 706-6411
- NPI assigned
- Mar 28, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW-36137 | ID | Primary |
Addresses
Primary practice location
4949 S Hillsdale Ave
Meridian, ID 83642-7586
Mailing address
190 E Bannock St
Boise, ID 83712-6241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 87.3 of 100
- Quality
- 81.29
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.37
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-36137 | ID | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St Lukes Clinic-Treasure Valley LLC | Current | Accepting new patients | |
| J. Bubba Legg Counseling LLC | Current | Accepting new patients | |
| St Lukes Regional Medical Center | Past | Accepting new patients |
Locations
190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378
610 W Hays St
Boise, ID 83702
Phone (208) 345-3530
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Counseling Psychologist
- Albany, OR
- NPI 1871489716
-
- Family Medicine Physician
- Boise, ID
- NPI 1326336058
-
dba St Lukes Meridian Medical Center
- General Acute Care Hospital
- Boise, ID
- NPI 1770586794
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649894400000",
"number": "1255081683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "190 E BANNOCK ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837126241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4949 S HILLSDALE AVE",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "836427586",
"telephone_number": "208-706-6400",
"fax_number": "208-706-6411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGG",
"first_name": "JEREMIAH",
"middle_name": "S",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-03-28",
"last_updated": "2022-04-14",
"certification_date": "2022-04-14",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ID",
"license": "LCSW-36137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Meridian, ID
- Legacy Home Care LC (Legacy Home Health Care)
- Legacy Hospice Care, LLC (Legacy home health and hospice)
- Legacy Hospice II, LLC (Compassus Hospital Boise)
- Legacy Primary Care, LLC
- Legacy Smiles Family Dental, PLLC
- Legion Medical LLC (Embrace Psychiatry)
- Diann Lei, BA
- Maria Leibler, DPT
- Lejax Holdings, LLC (DBA Snake River Acupuncture, Pain Relief and Rehabilitation)
- Laura Lemons, CPM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.