Legacy Family Care PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LEGACY FAMILY CARE PLLC

Practice address

23800 Orchard Lake Rd Ste 202
Farmington Hills, MI 48336-2562

Phone

(248) 997-5964

NPI assigned

Jan 8, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Samuel Park

Title

Practice Administrator

Phone

(248) 997-5964

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 3

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

• Heather Koza, MD

  • Family Medicine Physician
  • Farmington Hills, MI
  • NPI 1194045526
  Medicare reassignment NPD
• Suma Thomas, D.O.

  • Family Medicine Physician
  • Lansing, MI
  • NPI 1407272206
  Medicare reassignment NPD
• Farrah Thwainey

  • Registered Dietitian
  • Novi, MI
  • NPI 1700396868
  Medicare reassignment NPD

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

{
    "created_epoch": "1736294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754611200000",
    "number": "1841000361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD STE 202",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362562",
            "telephone_number": "248-997-5964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23800 ORCHARD LAKE RD STE 202",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483362562",
            "telephone_number": "248-997-5964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY FAMILY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "248-997-5964",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Fenton Leff, DO
• Jennifer Leffler
• Joan Leffler
• Yvette Leflore
• Kennedy Leftwich
• Priscila Legarda
• Mary Legaspi
• Oriana Lege
• Margaret Legel
• Legend Tales

• Family Medicine Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.