Organization Active NPI

Legacy of Four Sisters LLC

  • Driver
  • Appleton, WI
National Provider Identifier
1699697847
Registry record updated Aug 9, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Legal business name
LEGACY OF FOUR SISTERS LLC
Practice address
N9351 S Lake Park Rd Unit 132
Appleton, WI 54915-9488
Phone
(920) 515-1534
NPI assigned
Jul 29, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2026

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

Authorized official

Name
Dyna Ingabire
Title
Director
Phone
(920) 515-1534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X Primary

Addresses

Primary practice location

N9351 S Lake Park Rd Unit 132
Appleton, WI 54915-9488

Mailing address

N9351 S Lake Park Rd Unit 132
Appleton, WI 54915-9488
Phone (920) 515-1534

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1785283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786233600000",
    "number": "1699697847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "N9351 S LAKE PARK RD UNIT 132",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549159488",
            "telephone_number": "920-515-1534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "N9351 S LAKE PARK RD UNIT 132",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549159488",
            "telephone_number": "920-515-1534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY OF FOUR SISTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-29",
        "last_updated": "2026-08-09",
        "certification_date": "2026-08-09",
        "status": "A",
        "authorized_official_last_name": "INGABIRE",
        "authorized_official_first_name": "DYNA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "920-515-1534"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2026; 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.