NPIMap

Organization Active NPI

Legacy Nurse Practitioners Mobile Healthcare, LLC

  • Nurse Practitioner
  • Columbus, OH
National Provider Identifier
1326566738
Registry record updated May 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
LEGACY NURSE PRACTITIONERS MOBILE HEALTHCARE, LLC
Practice address
5797 Beechcroft Rd Ste F
Columbus, OH 43229-2758
Phone
(614) 500-2500
Fax
(614) 369-3723
NPI assigned
Sep 6, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2019

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

Authorized official

Name
Victoria Overcomer, CNP
Title
Senior Nurse Practitioner
Phone
(614) 500-2500

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Clinic/Center 261Q00000X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary

Addresses

Primary practice location

5797 Beechcroft Rd Ste F
Columbus, OH 43229-2758

Mailing address

5797 Beechcroft Rd Ste F
Columbus, OH 43229-2758
Phone (614) 500-2500

Other identifiers 1

IdentifierTypeStateIssuer
0258578MedicaidOH

National Provider Directory

National Provider Directory

Locations

555 W Schrock Rd
Ste 110
Westerville, OH 43081
Phone (614) 500-2500

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/18818/brand/1/csg/1/fhir/r4

NPI Registry JSON

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

{
    "created_epoch": "1504656000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557705600000",
    "number": "1326566738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5797 BEECHCROFT RD STE F",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292758",
            "telephone_number": "614-500-2500",
            "fax_number": "614-369-3723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5797 BEECHCROFT RD STE F",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292758",
            "telephone_number": "614-500-2500",
            "fax_number": "614-369-3723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY NURSE PRACTITIONERS MOBILE HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-06",
        "last_updated": "2019-05-13",
        "status": "A",
        "authorized_official_last_name": "OVERCOMER",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "SENIOR NURSE PRACTITIONER",
        "authorized_official_telephone_number": "614-500-2500",
        "authorized_official_credential": "CNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0258578",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.