Legacy Visiting Health Services

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

LEGACY VISITING HEALTH SERVICES

Practice address

3660 Starrs Centre Dr
Canfield, OH 44406-8506

Phone

(330) 953-3077

Fax

(330) 953-3088

NPI assigned

Apr 25, 2012

Last updated

Dec 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Judy A Nystrom

Title

Ceo

Phone

(216) 570-3094

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1902164007. Details of each certification follow.

• CCN 368482 Home health agency · Active · Details

Home health agency certification: CCN 368482

Legal name

LEGACY VISITING HEALTH SERVICES

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Feb 28, 2013

Last certification

Nov 21, 2018

Ownership / control type

Proprietary

Organization structure

LLCProprietary

Enrollment address

3660 Starrs Centre Dr
Unit a
Canfield, OH 44406

Listed as

Legacy Visiting Health ServicesCCN 368482 · All quality measures

Ownership

Proprietary

Certified

Feb 28, 2013

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

Locations

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513641600000",
    "number": "1902164007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3660 STARRS CENTRE DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068506",
            "telephone_number": "330-953-3077",
            "fax_number": "330-953-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3660 STARRS CENTRE DR",
            "city": "CANFIELD",
            "state": "OH",
            "postal_code": "444068506",
            "telephone_number": "330-953-3077",
            "fax_number": "330-953-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY VISITING HEALTH SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2017-12-19",
        "status": "A",
        "authorized_official_last_name": "NYSTROM",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "216-570-3094",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Richard Kupec, PSY.D, LPCC
• Lakhani MD LLC
• Anne Lally, LPCC-S
• Karli Noelle Lash, BS, LSW
• Matthew S Leathers, PT, DPT
• Savannah Leslie
• Laura Lewis, MT
• Robert D. Lewis, M.D. LLC
• Brenda Kay Leyden
• Paula G Libbey, LISW

• Home Health Agency in Canfield, OH
• Providers in Canfield, OH by specialty
• Home Health Agency in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.