NPIMap

Organization Active NPI

Legacy Healthcare

  • Physical Disabilities Residential Treatment Facility
  • Raleigh, NC
National Provider Identifier
1376962621
Registry record updated Apr 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
License
2870 Issued in NC
Legal business name
LEGACY HEALTHCARE
Practice address
3001 Spring Forest Rd
Raleigh, NC 27616-2815
Phone
(919) 424-5080
NPI assigned
Apr 15, 2014
Last updated
Apr 15, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2014

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

Authorized official

Name
Ms. Kim Florene Fultz, LPTA
Title
Lpta
Phone
(336) 307-6056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X 2870 NC Primary

Addresses

Primary practice location

3001 Spring Forest Rd
Raleigh, NC 27616-2815

Mailing address

3001 Spring Forest Rd
Raleigh, NC 27616-2815
Phone (919) 424-5080

National Provider Directory

National Provider Directory
Tax ID family
Legacy Healthcare Services61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 19

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397520000000",
    "number": "1376962621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162815",
            "telephone_number": "919-424-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162815",
            "telephone_number": "919-424-5080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A",
        "authorized_official_last_name": "FULTZ",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "FLORENE",
        "authorized_official_title_or_position": "LPTA",
        "authorized_official_telephone_number": "336-307-6056",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LPTA"
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": "NC",
            "license": "2870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; 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.