NPIMap

Organization Active NPI

Legacy Healthcare Services, Inc

  • Skilled Nursing Facility
  • Morganton, NC
National Provider Identifier
1881079929
Registry record updated Jul 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
License
5172 Issued in NC
Legal business name
LEGACY HEALTHCARE SERVICES, INC
Practice address
4263 Bill Dale Rd
Morganton, NC 28655
Phone
(828) 448-1137
NPI assigned
Jul 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2015

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

Authorized official

Name
Derrick Woodley Clark, PTA
Title
Pta
Phone
(828) 448-1137

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X 5172 NC
Skilled Nursing Facility 314000000X 5172 NC Primary

Addresses

Primary practice location

4263 Bill Dale Rd
Morganton, NC 28655

Mailing address

4263 Bill Dale Rd
Morganton, NC 28655-8854
Phone (828) 448-1137

National Provider Directory

National Provider Directory
Tax ID family
Legay Healthcare SVCS Inc61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438128000000",
    "number": "1881079929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4263 BILL DALE RD",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "286558854",
            "telephone_number": "828-448-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4263 BILL DALE RD",
            "city": "MORGANTON",
            "state": "NC",
            "postal_code": "28655",
            "telephone_number": "828-448-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2015-07-29",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "WOODLEY",
        "authorized_official_title_or_position": "PTA",
        "authorized_official_telephone_number": "828-448-1137",
        "authorized_official_credential": "PTA"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "NC",
            "license": "5172",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NC",
            "license": "5172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morganton, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.