NPIMap

Organization Active NPI

Legacy

  • Nursing Facility/Intermediate Care Facility
  • Yadkinville, NC
National Provider Identifier
1306284674
Registry record updated Jun 10, 2013
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Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
4645 Issued in NC
Legal business name
LEGACY
Practice address
903 W Main Street
Yadkinville, NC 27055
Phone
(336) 677-1345
NPI assigned
Jun 10, 2013
Last updated
Jun 10, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2013

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

Authorized official

Name
Mrs. Jessica Lindsey Bell, COTA/L
Title
Ota
Phone
(828) 729-2457

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 4645 NC Primary

Addresses

Primary practice location

903 W Main Street
Yadkinville, NC 27055

Mailing address

1222 NC Highway 801 N
Advance, NC 27006-6757
Phone (828) 729-2457

National Provider Directory

National Provider Directory
Tax ID family
Az Trans456 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 7

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

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

{
    "created_epoch": "1370822400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370822400000",
    "number": "1306284674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 NC HIGHWAY 801 N",
            "city": "ADVANCE",
            "state": "NC",
            "postal_code": "270066757",
            "telephone_number": "828-729-2457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 W MAIN STREET",
            "city": "YADKINVILLE",
            "state": "NC",
            "postal_code": "27055",
            "telephone_number": "336-677-1345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-10",
        "last_updated": "2013-06-10",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LINDSEY",
        "authorized_official_title_or_position": "OTA",
        "authorized_official_telephone_number": "828-729-2457",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "4645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yadkinville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2013; 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.