NPIMap

Organization Active NPI

Legacy Family Medical, PC

  • Primary Care Clinic/Center
  • Gilbert, AZ
National Provider Identifier
1508166620
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
110530 Issued in AZ
Legal business name
LEGACY FAMILY MEDICAL, PC
Practice address
4902 S Val Vista Dr
Suite 110
Gilbert, AZ 85298-7325
Phone
(480) 766-8485
Fax
(480) 689-5569
NPI assigned
Oct 22, 2010
Last updated
May 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Vicki Marquart, FNP-CNPI 1457301525
Title
President
Phone
(480) 766-8485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 110530 AZ Primary

Addresses

Primary practice location

4902 S Val Vista Dr
Suite 110
Gilbert, AZ 85298-7325

Mailing address

4902 S Val Vista Dr
Suite 110
Gilbert, AZ 85298-7325
Phone (480) 766-8485

National Provider Directory

National Provider Directory

Locations

4902 S Val Vista Dr
Ste 110
Gilbert, AZ 85298
Phone (480) 766-8485

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.

NPI Registry JSON

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

{
    "created_epoch": "1287705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1508166620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 S VAL VISTA DR",
            "address_2": "SUITE 110",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852987325",
            "telephone_number": "480-766-8485",
            "fax_number": "480-689-5569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 S VAL VISTA DR",
            "address_2": "SUITE 110",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852987325",
            "telephone_number": "480-766-8485",
            "fax_number": "480-689-5569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY FAMILY MEDICAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-22",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "MARQUART",
        "authorized_official_first_name": "VICKI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "480-766-8485",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "AZ",
            "license": "110530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.