NPIMap

Organization Active NPI

Legendary Support Coordination LLC

  • Case Management Agency
  • Philadelphia, PA
National Provider Identifier
1396122909
Registry record updated Jun 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
LEGENDARY SUPPORT COORDINATION LLC
Practice address
5860 Market St Apt 1
Philadelphia, PA 19139-3113
Phone
(215) 596-5940
NPI assigned
May 4, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2019

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

Authorized official

Name
Simone Marlena Bruce
Title
Administrator
Phone
(267) 231-9827

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

5860 Market St Apt 1
Philadelphia, PA 19139-3113

Mailing address

5860 Market St Apt 1
Philadelphia, PA 19139-3113
Phone (215) 596-5940

National Provider Directory

National Provider Directory
Tax ID family
Legendary Support Coordination LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559606400000",
    "number": "1396122909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5860 MARKET ST APT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393113",
            "telephone_number": "215-596-5940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5860 MARKET ST APT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191393113",
            "telephone_number": "215-596-5940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGENDARY SUPPORT COORDINATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2019-06-04",
        "status": "A",
        "authorized_official_last_name": "BRUCE",
        "authorized_official_first_name": "SIMONE",
        "authorized_official_middle_name": "MARLENA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "267-231-9827"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.