Legacy Active Living Retirement Community

Primary specialty

Alzheimer Center (Dementia Center)Taxonomy code 311500000X

License

S0163 Issued in IA

Legal business name

LEGACY ACTIVE LIVING RETIREMENT COMMUNITY

Doing business as

Legacy Gardens

Practice address

15 Silvercrest PL
Iowa City, IA 52240-2951

Phone

(319) 338-4404

NPI assigned

May 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Jim Hunter

Title

Executive Director

Phone

(319) 341-0911

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Legacy Gardens Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1952510018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S SCOTT BLVD",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402944",
            "telephone_number": "319-341-0911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 SILVERCREST PL",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522402951",
            "telephone_number": "319-338-4404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY ACTIVE LIVING RETIREMENT COMMUNITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUNTER",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "319-341-0911",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "IA",
            "license": "S0163",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280875",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Gardens",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ye-Jin Lee, MD
• Yongki Lee, MD
• Roongkit Ron Leehacharoenkul, D.D.S.
• Jason Lefkowitz, MD, PHD
• Legacy Active Living Retirement Community
• Ryan Keegan Lehmann, D.O.
• Lauri Jo Lehn, PHD
• Alyssa Lehnen, ARNP
• Connor Leichtle, LAT, ATC
• Brooke Rachelle Leichty, PA

• Alzheimer Center (Dementia Center) in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Alzheimer Center (Dementia Center) in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.