NPIMap

Organization Active NPI

Carolina Surgery Vein Clinic LLC

Doing business as Legacy Health and Wellness

  • Multi-Specialty Clinic/Center
  • Fort Mill, SC
National Provider Identifier
1285120741
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
CAROLINA SURGERY VEIN CLINIC LLC
Doing business as
Legacy Health and Wellness
Practice address
127 Ben Casey Dr Ste 106
Fort Mill, SC 29708
Phone
(803) 547-6800
Fax
(803) 547-6801
NPI assigned
Jul 9, 2018
Last updated
May 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Authorized official

Name
Mary Mallette Woods
Title
Office Manager
Phone
(803) 547-6800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

127 Ben Casey Dr Ste 106
Fort Mill, SC 29708

Mailing address

127 Ben Casey Dr Ste 106
Fort Mill, SC 29708-6600
Phone (803) 547-6800

Other names 1

  • Legacy Health and Wellness Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1531094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556755200000",
    "number": "1285120741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "127 BEN CASEY DR STE 106",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297086600",
            "telephone_number": "803-547-6800",
            "fax_number": "803-547-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "127 BEN CASEY DR STE 106",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "29708",
            "telephone_number": "803-547-6800",
            "fax_number": "803-547-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLINA SURGERY VEIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-09",
        "last_updated": "2019-05-02",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "MARY MALLETTE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "803-547-6800"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Health and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Mill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.