Active NPI
Legend Surgical Network
- Registered Nurse First Assistant
- Southlake, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse First Assistant
- License
- 605077
- Legal business name
- LEGEND SURGICAL NETWORK
- Practice address
- 1052 Summerplace LN
Southlake, TX 76092-5120 - Phone
- (817) 379-5600
- NPI assigned
- Sep 11, 2017
- Last updated
- Sep 11, 2017
- Organization subpart
- Yes
- Parent organization
- SURGICAL ALLIANCE INCORPORATED
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Northcutt
- Title
- Managing Member
- Phone
- (817) 379-5600
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse First Assistant | 163WR0006X | 605077 | TX | Primary |
Addresses
Primary practice location
1052 Summerplace LN
Southlake, TX 76092-5120
Mailing address
PO Box 92592
Southlake, TX 76092-0592
National Provider Directory
National Provider Directory- Part of
- Surgical Alliance Incorporated
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
-
- Registered Nurse First Assistant
- Southlake, TX
- NPI 1407068927
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.
-
- Registered Nurse First Assistant
- Southlake, TX
- NPI 1861580185
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1505088000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1505088000000",
"number": "1730608845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 92592",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760920592"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1052 SUMMERPLACE LN",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760925120",
"telephone_number": "817-379-5600"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LEGEND SURGICAL NETWORK",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SURGICAL ALLIANCE INCORPORATED",
"enumeration_date": "2017-09-11",
"last_updated": "2017-09-11",
"status": "A",
"authorized_official_last_name": "NORTHCUTT",
"authorized_official_first_name": "LISA",
"authorized_official_title_or_position": "MANAGING MEMBER",
"authorized_official_telephone_number": "817-379-5600"
},
"taxonomies": [
{
"code": "163WR0006X",
"taxonomy_group": "",
"desc": "Registered Nurse, Registered Nurse First Assistant",
"state": "TX",
"license": "605077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southlake, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.