Active NPI
Erin Nicole Legens
- Family Nurse Practitioner
- Dresden, TN
National Provider Identifier
1326430620
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 19668
- 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
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161229000780 | TN | Practitioner - Nurse Practitioner | 6507147857 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients | |
| Fast Pace Medical Clinic PLLC | Current |
Accepting new patients |
Locations
1705 W Reelfoot Ave
Union City, TN 38261
Phone (731) 599-1102
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 19668 | TN | Primary |
Addresses
NPPES NPI RegistryPrimary 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| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q015130 | Medicaid | TN | |
| 3380640 | Medicaid | TN |
Other names 1
NPPES NPI Registry- Erin Nicole Legens
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.