Legacy Healthcare Services Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LEGACY HEALTHCARE SERVICES INC

Practice address

1151 S Main St Apt 303
Wake Forest, NC 27587-9660

Phone

(919) 556-1336

NPI assigned

Nov 16, 2021

Last updated

Nov 16, 2021By 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

Mr. William G Wilson Jr.

Title

Cfo

Phone

(919) 424-5080

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Practitioners 6

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.

• Ashley Clary

  • Occupational Therapy Assistant
  • Wake Forest, NC
  • NPI 1710695838
  NPD
• Mackenzie Forman, CCC-SLP

  • Speech-Language Pathologist
  • Wake Forest, NC
  • NPI 1679821490
  NPD (past)
• Kimberly Jo Lampe, OTR

  • Occupational Therapist
  • Wake Forest, NC
  • NPI 1588838270
  NPD (past)
• Carol Leggett, PTA

  • Physical Therapy Assistant
  • Wake Forest, NC
  • NPI 1407256795
  NPD (past)
• Jignya Patel, PT

  • Physical Therapist
  • Wake Forest, NC
  • NPI 1720403017
  NPD (past)
• Kristina Lynn Wolfe, PT

  • Physical Therapist
  • Apex, NC
  • NPI 1689947533
  NPD (past)

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1265198907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HORIZON DR STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154926",
            "telephone_number": "919-424-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1151 S MAIN ST APT 303",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "275879660",
            "telephone_number": "919-556-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-424-5080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leading Light Services, PLLC
• Erica Marie Lear, M.S., CCC-SLP
• Kensley Sierra Ledford, MS SLP
• Caroline Lee, FNP-BC
• Theresa Lee, RPH
• Legacy Therapeutic Services
• Carol Leggett, PTA
• Saranne Nicole Lentz-Barker, AUD, CCC-A
• Jasmine Levy, NP
• Joan Ellen Levy, RN, IBCLC, LCCE,

• Physical Therapist in Wake Forest, NC
• Providers in Wake Forest, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.