Active NPI
Bluegrass Legacy Healthcare, PLLC
- Primary Care Clinic/Center
- Hendersonville, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- Legal business name
- BLUEGRASS LEGACY HEALTHCARE, PLLC
- Practice address
- 105 Glen Oak Blvd Ste 202
Hendersonville, TN 37075-3058 - Phone
- (615) 826-2265
- Fax
- (615) 826-4616
- NPI assigned
- Mar 4, 2021
- 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
- Mrs. Abigail Joan Eubank, GNP, MSN
- Title
- Owner
- Phone
- (615) 826-2265
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Geriatric Medicine (Family Medicine) Physician | 207QG0300X | |||
| Primary Care Clinic/Center | 261QP2300X | Primary |
Addresses
Primary practice location
105 Glen Oak Blvd Ste 202
Hendersonville, TN 37075-3058
Mailing address
105 Glen Oak Blvd Ste 202
Hendersonville, TN 37075-3058
Phone (615) 826-2265
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4112769 | Other | TN | BCBST |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
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 |
|---|---|---|---|
| 44D0950242 | Bluegrass Legacy Healthcare PLLC | Certificate of waiver | Aug 20, 2026 |
National Provider Directory
National Provider DirectoryLocations
353 New Shackle Island Rd
Ste 245C
Hendersonvlle, TN 37075
Phone (615) 826-2265
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Primary Care Nurse Practitioner
- Hendersonville, TN
- NPI 1588861207
Geriatric Medicine
-
- Family Medicine Physician
- Hendersonville, TN
- NPI 1487778635
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1614816000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1779926400000",
"number": "1467047258",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 GLEN OAK BLVD STE 202",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370753058",
"telephone_number": "615-826-2265",
"fax_number": "615-826-4616"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 GLEN OAK BLVD STE 202",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370753058",
"telephone_number": "615-826-2265",
"fax_number": "615-826-4616"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BLUEGRASS LEGACY HEALTHCARE, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-03-04",
"last_updated": "2026-05-28",
"certification_date": "2026-05-28",
"status": "A",
"authorized_official_last_name": "EUBANK",
"authorized_official_first_name": "ABIGAIL",
"authorized_official_middle_name": "JOAN",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "615-826-2265",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "GNP, MSN"
},
"taxonomies": [
{
"code": "207QG0300X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Geriatric Medicine",
"state": null,
"license": null,
"primary": false
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBST",
"identifier": "4112769",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.