Legacy Healthcare Services, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LEGACY HEALTHCARE SERVICES, INC

Doing business as

Legacy Rehabilitation Services, Inc.

Practice address

5400 Laurel Lake Dr
Waco, TX 76710-2835

Phone

(254) 399-6633

Fax

(254) 399-6647

NPI assigned

Feb 24, 2014

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

Chief Financial Officer

Phone

(919) 424-5080

Specialties & licenses 3

Addresses

Other names 1

• Legacy Rehabilitation Services, Inc. Doing business as

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

{
    "created_epoch": "1393200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733443200000",
    "number": "1316362650",
    "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",
            "fax_number": "919-431-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5400 LAUREL LAKE DR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767102835",
            "telephone_number": "254-399-6633",
            "fax_number": "254-399-6647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-24",
        "last_updated": "2024-12-06",
        "certification_date": "2024-12-06",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "919-424-5080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Rehabilitation Services, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Derek Dongwoo Lee, M.D.
• Katherine Elizabeth Lee, DC
• Linn Lee, OT
• McKenzie Lee
• Jordan Paul Leep, ATC, LAT
• Legacy Medical Imaging
• Legiang Holdings LLC
• Weston Mark Lehman, M.D.
• Ronald Edward Leifeste, DDS
• Jeffrey Joseph Leinfelder, M.D.

• Physical Therapist in Waco, TX
• Providers in Waco, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2024; 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.