Legacy Healthcare Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LEGACY HEALTHCARE INC

Doing business as

Legacy Physical Therapy & Sports Training

Practice address

8175 US Highway 301 N
Parrish, FL 34219-8669

Phone

(941) 729-0003

Fax

(941) 729-0004

NPI assigned

May 18, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Cesar Chacon

Title

Administrator

Phone

(941) 302-9400

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Legacy Physical Therapy & Sports Training Doing business as

Locations

Practitioners 3

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

• Vanessa Rae Ballard, PT

  • Physical Therapist
  • Sarasota, FL
  • NPI 1679766737
  NPD (past)
• Alan Daniel Dalton, PT, MPT, OCS

  • Physical Therapist
  • Venice, FL
  • NPI 1295777258
  NPD (past)
• Jennifer Lynn Kotlarczyk, PT

  • Physical Therapist
  • Sarasota, FL
  • NPI 1083656185
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1710930771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1156",
            "city": "ELLENTON",
            "state": "FL",
            "postal_code": "342221156",
            "telephone_number": "941-729-0003",
            "fax_number": "941-729-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 US HIGHWAY 301 N",
            "city": "PARRISH",
            "state": "FL",
            "postal_code": "342198669",
            "telephone_number": "941-729-0003",
            "fax_number": "941-729-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-18",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "CHACON",
        "authorized_official_first_name": "CESAR",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "941-302-9400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888322000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP PROV NUMBER",
            "identifier": "2989794",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Physical Therapy & Sports Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phuong Anh Le, RPH
• Roshni Marballi Leboutillier, DO
• Amanda Bryn Lee, ARNP
• Legacy Healthcare Inc (Legacy Physical Therapy & Sports Training)
• Legacy Healthcare Inc (Legacy Physical Therapy & Sports Training)
• Kelly Marie Lehman, LPC, M.ED, NCC
• Brittney Leibham
• Deborah A Lenart, MD
• Amy L Lewis, PA-C
• Carol S Lewis, PA

• Physical Therapist in Parrish, FL
• Providers in Parrish, FL by specialty
• Physical Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.