Legacy Primary Care, PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LEGACY PRIMARY CARE, PLLC

Practice address

3401 N Calais Dr Ste a
Sherman, TX 75090-3104

Phone

(903) 957-9010

Fax

(903) 957-0585

NPI assigned

May 28, 2021

Organization subpart

No

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

Authorized official

Name

Andrea Hughes, DONPI 1124516802

Title

Owner

Phone

(205) 353-5831

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrea Hughes, D.O.

  • Family Medicine Physician
  • Sherman, TX
  • NPI 1124516802

  Family Medicine, TX

  Medicare reassignment NPD Authorized official
• Bethany Boatner

  • Physician Assistant
  • Sherman, TX
  • NPI 1275942856
  NPD (past)
• Jennifer Owen Myers, NP

  • Nurse Practitioner
  • Denison, TX
  • NPI 1891104576
  NPD (past)
• Cheryl Fish, NP

  • Nurse Practitioner
  • Boise, ID
  • NPI 1083185235

  Family Medicine

  NPD (past)
• Heather Ann Stafford, NP-C

  • Adult Health Nurse Practitioner
  • Boise, ID
  • NPI 1912416413
  NPD (past)
• Bailey Tomazich

  • Family Nurse Practitioner
  • Boise, ID
  • NPI 1871200758
  NPD (past)

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

{
    "created_epoch": "1622160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622160000000",
    "number": "1255907473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 837",
            "city": "HOWE",
            "state": "TX",
            "postal_code": "754590837",
            "telephone_number": "903-487-2248",
            "fax_number": "903-487-2306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N CALAIS DR STE A",
            "city": "SHERMAN",
            "state": "TX",
            "postal_code": "750903104",
            "telephone_number": "903-957-9010",
            "fax_number": "903-957-0585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PRIMARY CARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-28",
        "last_updated": "2021-05-28",
        "certification_date": "2021-05-28",
        "status": "A",
        "authorized_official_last_name": "HUGHES",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-353-5831",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Lee
• Luke Hongryul Lee, PHARM.D.
• Paola Berenice Lee, REGISTERED NURSE
• Sarah May Lee
• Kaitlin Leffert
• Roy Edward Lehman, MD
• Nickson Leo, PHARM.D.
• Rebecca Anne Leonhardt, RN
• Level One Emergency Specialists LLC
• Lewis Chiropractic PC

• All providers in Sherman, TX
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.