NPIMap

Organization Active NPI

Legacy Vein Center PLLC

  • Vascular Surgery Physician
  • Johnson City, TN
National Provider Identifier
1477972933
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
LEGACY VEIN CENTER PLLC
Practice address
215 E Watauga Ave
Johnson City, TN 37601-4629
Phone
(423) 328-0163
Fax
(423) 491-8109
NPI assigned
Apr 14, 2014
Last updated
Oct 19, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Authorized official

Name
Ginger Reece
Title
Director of Operations
Phone
(423) 956-2682

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

215 E Watauga Ave
Johnson City, TN 37601-4629

Mailing address

215 E Watauga Ave
Johnson City, TN 37601-4629
Phone (423) 328-0163

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, VA3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20160824000796 TN Part B Supplier - Clinic/Group Practice 2264727627 Receives reassigned benefits from 24 practitioners
Practice locations: Chattanooga, TN; Johnson City, TN; Kingsport, TN; Knoxville, TN; Morristown, TN; Oak Ridge, TN; Sevierville, TN
O20200515000961 VA Part B Supplier - Clinic/Group Practice 2264727627 Receives reassigned benefits from 8 practitioners
Practice locations: Abingdon, VA
O20210630002716 TN DME Supplier - Physician - Internal Medicine 2264727627 Practice locations: Johnson City, TN

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

310 N State of Franklin Rd
Ste 102
Johnson City, TN 37604
Phone (423) 431-3600

310 N State of Franklin Rd
Ste 103
Johnson City, TN 37604
Phone (423) 232-8301

109 Jack White Dr
Kingsport, TN 37664
Phone (423) 245-1022

444 Clinchfield St
Ste 2811
Kingsport, TN 37660

6 Sheridan Sq
Ste 100
Kingsport, TN 37660
Phone (423) 228-0163

4327 W Andrew Johnson Hwy
Ste 4
Morristown, TN 37814
Phone (423) 714-0880

800 Oak Ridge Tpke
Ste C260
Oak Ridge, TN 37830
Phone (865) 234-1090

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1397433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792368000000",
    "number": "1477972933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014629",
            "telephone_number": "423-328-0163",
            "fax_number": "423-491-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E WATAUGA AVE",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376014629",
            "telephone_number": "423-328-0163",
            "fax_number": "423-491-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY VEIN CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-14",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A",
        "authorized_official_last_name": "REECE",
        "authorized_official_first_name": "GINGER",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "423-956-2682"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.