Individual provider Active NPI

Justine Elena Legrand, CPM, LM

  • Midwife
  • Fort Worth, TX
National Provider Identifier
1801382528
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
99342 Issued in TX
Practice address
10345 Alta Vista Rd
Fort Worth, TX 76244-6501
Phone
(817) 562-2828
Fax
(817) 768-6940
NPI assigned
Jul 5, 2018
Last updated
Jul 5, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 99342 TX Primary

Addresses

Primary practice location

10345 Alta Vista Rd
Fort Worth, TX 76244-6501

Mailing address

8413 Springhill CT
North Richland Hills, TX 76182-6134
Phone (817) 994-7135

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
99342TXMDMidwife

NPI Registry JSON

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

{
    "created_epoch": "1530748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1801382528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8413 SPRINGHILL CT",
            "city": "NORTH RICHLAND HILLS",
            "state": "TX",
            "postal_code": "761826134",
            "telephone_number": "817-994-7135",
            "fax_number": "817-768-6940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10345 ALTA VISTA RD",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762446501",
            "telephone_number": "817-562-2828",
            "fax_number": "817-768-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGRAND",
        "first_name": "JUSTINE",
        "middle_name": "ELENA",
        "name_prefix": "Mrs.",
        "credential": "CPM, LM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-05",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "TX",
            "license": "99342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2018; 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.