NPIMap

Organization Active NPI

The Patricia Hall Talbott Legacy Centers, LLC

  • Clinic/Center
  • Maryville, TN
National Provider Identifier
1649897802
Registry record updated Nov 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
THE PATRICIA HALL TALBOTT LEGACY CENTERS, LLC
Practice address
1821 W Broadway Ave
Maryville, TN 37801-5511
Phone
(865) 964-5748
NPI assigned
Jul 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2021

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

Authorized official

Name
Zachary Charles Talbott, LMSW, LADAC, MACNPI 1083157085
Title
President
Phone
(865) 724-0852

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary
Methadone Clinic 261QM2800X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

1821 W Broadway Ave
Maryville, TN 37801-5511

Mailing address

1821 W Broadway Ave
Maryville, TN 37801-5511
Phone (865) 724-0852

Other names 1

  • Talbott Legacy Centers Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Opioid treatment program
Medicare-enrolled since Sep 30, 2021

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220215001351 TN Part B Supplier - Opioid Treatment Program (Otp) 2365835303 Practice locations: Maryville, TN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1593648000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636156800000",
    "number": "1649897802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1821 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378015511",
            "telephone_number": "865-724-0852",
            "fax_number": "865-724-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1821 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378015511",
            "telephone_number": "865-964-5748"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PATRICIA HALL TALBOTT LEGACY CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-02",
        "last_updated": "2021-11-06",
        "certification_date": "2021-10-22",
        "status": "A",
        "authorized_official_last_name": "TALBOTT",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-724-0852",
        "authorized_official_credential": "LMSW, LADAC, MAC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2800X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Methadone",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Talbott Legacy Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2021; 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.