Organization Active NPI

Legacy Healthcare Services Inc

  • Physical Therapist
  • Troy, MI
National Provider Identifier
1912505322
Registry record updated Dec 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LEGACY HEALTHCARE SERVICES INC
Practice address
3400 Livernois Rd
Troy, MI 48083-5231
Phone
(248) 817-5666
NPI assigned
Oct 16, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2021

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

Authorized official

Name
Mr. William Gill Wilson Jr.
Title
Cfo
Phone
(919) 424-5080

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

3400 Livernois Rd
Troy, MI 48083-5231

Mailing address

110 Horizon Dr Ste 310
Raleigh, NC 27615-4926
Phone (919) 424-5080

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1602806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638489600000",
    "number": "1912505322",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 HORIZON DR STE 310",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276154926",
            "telephone_number": "919-424-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 LIVERNOIS RD",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480835231",
            "telephone_number": "248-817-5666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-16",
        "last_updated": "2021-12-03",
        "certification_date": "2021-12-03",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GILL",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "919-424-5080",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2021; 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.