NPIMap

Organization Active NPI

Legacy Healthcare Inc

Doing business as Legacy Physical Therapy & Sports Training

  • Physical Therapist
  • Sarasota, FL
National Provider Identifier
1306883962
Registry record updated Jun 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LEGACY HEALTHCARE INC
Doing business as
Legacy Physical Therapy & Sports Training
Practice address
3030 University Pkwy
Sarasota, FL 34243-2502
Phone
(941) 359-8233
Fax
(941) 359-8255
NPI assigned
Jun 1, 2006
Last updated
Jun 2, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2010

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

Authorized official

Name
Mr. Cesar Chacon
Title
Administrator
Phone
(941) 302-9400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

3030 University Pkwy
Sarasota, FL 34243-2502

Mailing address

8175 US Highway 301 N
Parrish, FL 34219-8669
Phone (941) 729-0003

Other identifiers 3

IdentifierTypeStateIssuer
2989794OtherFLAETNA GROUP PROV NUMBER
RZ5OtherFLBCBS FACILITY ID
888322000MedicaidFL

Other names 1

  • Legacy Physical Therapy & Sports Training Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1149120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275436800000",
    "number": "1306883962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 US HIGHWAY 301 N",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342198669",
            "telephone_number": "941-729-0003",
            "fax_number": "941-729-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 UNIVERSITY PKWY",
            "city": "SARASOTA",
            "state": "FL",
            "postal_code": "342432502",
            "telephone_number": "941-359-8233",
            "fax_number": "941-359-8255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-06-02",
        "status": "A",
        "authorized_official_last_name": "CHACON",
        "authorized_official_first_name": "CESAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "941-302-9400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP PROV NUMBER",
            "identifier": "2989794",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACILITY ID",
            "identifier": "RZ5",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888322000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Physical Therapy & Sports Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sarasota, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2010; 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.