Legacy Healthcare

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

AG03180006 Issued in TX

Legal business name

LEGACY HEALTHCARE

Practice address

1918 Santa Anna Dr
Arlington, TX 76001-5611

Phone

(817) 201-4503

Fax

(682) 238-3180

NPI assigned

May 5, 2018

Organization subpart

No

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

Authorized official

Name

Yonah Knuckles, NURSE PRACTITIONER

Title

Administrator

Phone

(817) 201-4503

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1525478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1525478400000",
    "number": "1912496985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1918 SANTA ANNA DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760015611",
            "telephone_number": "817-201-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 SANTA ANNA DR",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760015611",
            "telephone_number": "817-201-4503",
            "fax_number": "682-238-3180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-05",
        "last_updated": "2018-05-05",
        "status": "A",
        "authorized_official_last_name": "KNUCKLES",
        "authorized_official_first_name": "YONAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "817-201-4503",
        "authorized_official_credential": "NURSE PRACTITIONER"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "AG03180006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• R Jon Leffingwell
• Thomas F Leffingwell, MD
• Kimberly J Lefholz, DO
• Channon Lynne Leflore Smith
• Legacy Counseling & Life Coaching LLC
• Legacy Sleep Care LLC
• Vicki Legalley
• Lauren Legardye
• Peter Lehmann, PH.D.
• Brannon Leinart

• Gerontology Nurse Practitioner in Arlington, TX
• Providers in Arlington, TX by specialty
• Gerontology Nurse Practitioner in Texas

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