Andrea Kay Legg, MS, ATC, LAT

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT680 Issued in OK

Practice address

4401 S Czech Hall Rd
Mustang, OK 73064-9571

Phone

(505) 249-6925

NPI assigned

Feb 16, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1424044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1356732002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "513 SEQUOIA DR",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750415156",
            "telephone_number": "505-249-6925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 S CZECH HALL RD",
            "city": "MUSTANG",
            "state": "OK",
            "postal_code": "730649571",
            "telephone_number": "505-249-6925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGG",
        "first_name": "ANDREA",
        "middle_name": "KAY",
        "credential": "MS, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-16",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT4686",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "OK",
            "license": "AT680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zachary Laster
• Brian Christopher Lee, COTA/L
• Payton Lee
• Britini Leep, MS, ATC, LAT
• Legacy Family Services LLC
• Braxton Jace Legg
• Leisha V. Everett,DDS,PC
• Candace Nicole Lewis, LPC
• Jamey Rochelle Little, D.C.
• Terriana Loggins

• Athletic Trainer in Mustang, OK
• Providers in Mustang, OK by specialty
• Athletic Trainer in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.