Active NPI
The Legacy Willow Bend, Inc.
Doing business as The Legacy at Willow Bend
- Skilled Nursing Facility
- Plano, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Skilled Nursing Facility
- Legal business name
- THE LEGACY WILLOW BEND, INC.
- Doing business as
- The Legacy at Willow Bend
- Practice address
- 6101 Ohio Dr Ste 500
Plano, TX 75024-2733 - Phone
- (972) 468-6300
- Fax
- (972) 468-6214
- NPI assigned
- Dec 24, 2007
- Last updated
- Feb 28, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Terry Purchal
- Title
- Cfo
- Phone
- (972) 468-6176
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Skilled Nursing Facility | 314000000X | Primary |
Addresses
Primary practice location
6101 Ohio Dr Ste 500
Plano, TX 75024-2733
Mailing address
6101 Ohio Dr Ste 500
Plano, TX 75024-2733
Phone (972) 468-6277
Other names 1
- The Legacy at Willow Bend
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080328000445 | TX | Part A Provider - Skilled Nursing Facility | 0143306266 | Practice locations: Plano, TX |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1396929543. Details of each certification follow.
Skilled nursing facility certification: CCN 676189
- Legal name
- THE LEGACY WILLOW BEND, INC.
- Doing business as
- THE LEGACY AT WILLOW BEND
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF distinct part
- Participating since
- Jul 24, 2008
- Last certification
- Sep 19, 2024
- Beds
- 60
- Ownership / control type
- Nonprofit Corporation
- Multi-facility organization
- Legacy Senior Communities
- Organization structure
- Corporation
- Incorporated
- May 3, 2005 in TX
- Enrollment address
- 6101 Ohio Dr
Ste 500
Plano, TX 75024-2733 - Nursing home name
- THE LEGACY AT WILLOW BEND
Care Compare: Nursing home
Medicare Care Compare- Listed as
- The Legacy at Willow Bend
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- Non profit - Corporation
- Certified
- Jul 24, 2008
- Medicare certification status
- Active
- Certified beds
- 60
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 45D2303090 | Curana Health Clinic at Legacy Willow Bend | Certificate of waiver | Apr 18, 2028 |
National Provider Directory
National Provider Directory- Tax ID family
- The Legacy at Willow Bend Retirement Community Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Assisted Living Facility
- Plano, TX
- NPI 1740458108
Locations
6101 Ohio Dr
Ste 500
Plano, TX 75024
Phone (972) 468-6176
Ownership & related parties
All disclosed owners & managing parties 7
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| The Legacy Willow Bend, Inc. | 5% Or Greater Direct Ownership Interest | Oct 1, 2019 | 100% |
| Adp of the SNF | Oct 12, 2006 | ||
| Lakeesha Jenkins | Adp of the SNF | Mar 7, 2022 | |
| Bridgette Walshe | Corporate Officer | Sep 24, 2021 | |
| Adp of the SNF | Sep 24, 2021 | ||
| The Legacy Senior Communities Inc | Operational/Managerial Control | Oct 1, 2022 | |
| Adp of the SNF | Apr 15, 2025 | ||
| Vaqar Dar | Adp of the SNF | Apr 1, 2012 | |
| Scott Snorton | Corporate Officer | Jun 3, 2024 | |
| Adp of the SNF | Jun 3, 2024 | ||
| Deanna Stansbury | Operational/Managerial Control | Apr 6, 2022 | |
| Adp of the SNF | Apr 6, 2022 |
Owners & managing parties with NPI records 1
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
Facilities with the same owner 2
Facilities that share an organizational owner with 5% or greater ownership or operational control.
-
dba Legacy at Home
- Home Health Agency
- Plano, TX
- NPI 1225349376
The Legacy Senior Communities Inc
-
- Skilled Nursing Facility
- Dallas, TX
- NPI 1013546118
The Legacy Senior Communities Inc
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1184643728
Affiliated clinicians 3
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Orthopaedic Surgery of the Spine Physician
- Addison, TX
- NPI 1730506072
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198454400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1646006400000",
"number": "1396929543",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6101 OHIO DR STE 500",
"city": "PLANO",
"state": "TX",
"postal_code": "750242733",
"telephone_number": "972-468-6277",
"fax_number": "972-468-6214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6101 OHIO DR STE 500",
"city": "PLANO",
"state": "TX",
"postal_code": "750242733",
"telephone_number": "972-468-6300",
"fax_number": "972-468-6214"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE LEGACY WILLOW BEND, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-24",
"last_updated": "2022-02-28",
"certification_date": "2022-02-28",
"status": "A",
"authorized_official_last_name": "PURCHAL",
"authorized_official_first_name": "TERRY",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "972-468-6176"
},
"taxonomies": [
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "The Legacy at Willow Bend",
"code": "3",
"type": "Doing Business As"
},
{
"organization_name": "The Legacy at Willow Bend",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Plano, TX
- The Knead Medmassage LLC
- The Leavitt Group, LLP
- The Legacy at Home, Inc. (Legacy at Home)
- The Legacy at Home, Inc.
- The Legacy at Willow Bend Retirement Community Inc.
- The Lounge Collective
- The Montfort Group, PLLC
- The Muscle Therapy Clinic
- The Outlook at Windhaven Forefront Living
- The Pain Relief Center, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.