Individual provider Active NPI

Erin Nicole Legens

  • Family Nurse Practitioner
  • Dresden, TN
National Provider Identifier
1326430620
Registry record updated Jun 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
19668 Issued in TN
Practice address
136 S Wilson St
Dresden, TN 38225-1133
Phone
(731) 364-4900
Fax
(731) 352-4459
NPI assigned
Feb 23, 2015
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20161229000780 TN Practitioner - Nurse Practitioner 6507147857 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC Current
since Dec 11, 2016
Accepting new patients
Fast Pace Medical Clinic PLLC Current
since Dec 11, 2016
Accepting new patients

Locations

1705 W Reelfoot Ave
Union City, TN 38261
Phone (731) 599-1102

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 19668 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

136 S Wilson St
Dresden, TN 38225-1133

Mailing address

205 Hospital Dr Ste a
MC Kenzie, TN 38201-1649
Phone (731) 352-7907

Other practice location 1

1250 S Manufacturers Row
Trenton, TN 38382-3632
Phone (731) 855-7601

Other practice location 2

205 Hospital Dr Ste A
Mc Kenzie, TN 38201-1649
Phone (731) 352-7907

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
Q015130MedicaidTN
3380640MedicaidTN

Other names 1

NPPES NPI Registry
  • Erin Nicole Legens Former name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jun 26, 2019.

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561507200000",
    "number": "1326430620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 HOSPITAL DR STE A",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382011649",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 S WILSON ST",
            "city": "DRESDEN",
            "state": "TN",
            "postal_code": "382251133",
            "telephone_number": "731-364-4900",
            "fax_number": "731-352-4459"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1250 S Manufacturers Row",
            "address_purpose": "LOCATION",
            "city": "Trenton",
            "state": "TN",
            "postal_code": "383823632",
            "country_code": "US",
            "telephone_number": "731-855-7601",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Hospital Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Mc Kenzie",
            "state": "TN",
            "postal_code": "382011649",
            "country_code": "US",
            "telephone_number": "731-352-7907",
            "fax_number": "731-352-4459",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEGENS",
        "first_name": "ERIN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2019-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "19668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q015130",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3380640",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ERIN",
            "last_name": "LEGENS",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dresden, TN

Sources for this page

Verify at the official NPI Registry.