Organization Active NPI

Legacy Integrated Health LLC

  • Women's Health Nurse Practitioner
  • Colorado Springs, CO
National Provider Identifier
1790608313
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
Legal business name
LEGACY INTEGRATED HEALTH LLC
Practice address
3585 Van Teylingen Dr Ste G
Colorado Springs, CO 80917-4872
Phone
(719) 649-9345
NPI assigned
Jul 31, 2026
Last updated
Jul 31, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
LEGACY INTEGRATED HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Authorized official

Name
Demetra Seriki, APRNNPI 1790168425
Title
Provider/Administrator
Phone
(719) 649-9345

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Surgical Family Planning Clinic/Center 261QF0050X NU
Nurse Practitioner 363L00000X NU
Women's Health Nurse Practitioner 363LW0102X NU Primary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NU

Addresses

Primary practice location

3585 Van Teylingen Dr Ste G
Colorado Springs, CO 80917-4872

Mailing address

3585 Van Teylingen Dr Ste G
Colorado Springs, CO 80917-4872
Phone (719) 649-9345

National Provider Directory

National Provider Directory

Locations

3585 Van Teylingen Dr
Ste G
Colorado Springs, CO 80917
Phone (719) 425-2631

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": "1785456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785456000000",
    "number": "1790608313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 VAN TEYLINGEN DR STE G",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174872",
            "telephone_number": "719-649-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3585 VAN TEYLINGEN DR STE G",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809174872",
            "telephone_number": "719-649-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY INTEGRATED HEALTH LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LEGACY INTEGRATED HEALTH LLC",
        "enumeration_date": "2026-07-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A",
        "authorized_official_last_name": "SERIKI",
        "authorized_official_first_name": "DEMETRA",
        "authorized_official_title_or_position": "PROVIDER/ADMINISTRATOR",
        "authorized_official_telephone_number": "719-649-9345",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QF0050X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Family Planning, Non-Surgical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.