NPIMap

Organization Active NPI

Legacy Primary Healthcare, LLC

  • Family Nurse Practitioner
  • Tucson, AZ
National Provider Identifier
1447605274
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP4903 Issued in AZ
Legal business name
LEGACY PRIMARY HEALTHCARE, LLC
Practice address
7959 N Thornydale Rd
#91933
Tucson, AZ 85741-1443
Phone
(520) 975-4883
NPI assigned
Apr 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

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

Authorized official

Name
Jameela Ameen, NP-C
Title
Ms./Owner
Phone
(520) 975-4883

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X AP4903 AZ Primary

Addresses

Primary practice location

7959 N Thornydale Rd
#91933
Tucson, AZ 85741-1443

Mailing address

7959 N Thornydale Rd
#91933
Tucson, AZ 85741-1443
Phone (520) 975-4883

Other identifiers 1

IdentifierTypeStateIssuer
803226MedicaidAZ

National Provider Directory

National Provider Directory
Tax ID family
Legacy Primary Healthcare2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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": "1461888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1447605274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7959 N THORNYDALE RD",
            "address_2": "#91933",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857411443",
            "telephone_number": "520-975-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7959 N THORNYDALE RD",
            "address_2": "#91933",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857411443",
            "telephone_number": "520-975-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PRIMARY HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "AMEEN",
        "authorized_official_first_name": "JAMEELA",
        "authorized_official_title_or_position": "MS./OWNER",
        "authorized_official_telephone_number": "520-975-4883",
        "authorized_official_credential": "NP-C"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP4903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "803226",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.