NPIMap

Organization Active NPI

Legacy Healthcare Inc

  • Physical Therapist
  • Bradenton, FL
National Provider Identifier
1861446437
Registry record updated Aug 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LEGACY HEALTHCARE INC
Practice address
1880 59TH St W
Bradenton, FL 34209-4630
Phone
(941) 792-0511
Fax
(941) 792-0560
NPI assigned
May 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2015

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

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

1880 59TH St W
Bradenton, FL 34209-4630

Mailing address

PO Box 1156
Ellenton, FL 34222-1156
Phone (941) 729-0003

Other identifiers 4

IdentifierTypeStateIssuer
888322000MedicaidFL
DB5339OtherFLRAIL ROAD
Y910ZOtherFLBCBS FACILITY NUMBER
2989794OtherFLAETNA GROUP PROVIDER NUM

Other names 1

  • Legacy Physical Therapy & Sports Training Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Legacy Healthcare Inc5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1439942400000",
    "number": "1861446437",
    "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": "1880 59TH ST W",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342094630",
            "telephone_number": "941-792-0511",
            "fax_number": "941-792-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2015-08-19",
        "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": "RAIL ROAD",
            "identifier": "DB5339",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FACILITY NUMBER",
            "identifier": "Y910Z",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA GROUP PROVIDER NUM",
            "identifier": "2989794",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Physical Therapy & Sports Training",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bradenton, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.