Legacy Healthcare Services Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

LEGACY HEALTHCARE SERVICES INC

Practice address

4131 Andrew Jackson Pkwy
Hermitage, TN 37076-2270

Phone

(855) 289-3467

NPI assigned

Mar 1, 2021

Organization subpart

No

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

Authorized official

Name

Mr. William Gil Wilson Jr.

Title

Chief Financial Officer

Phone

(919) 424-5080

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Tax ID family

Legacy61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 2

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

• Legacy Healthcare Services Inc

  • Physical Therapist
  • Clarksville, TN
  • NPI 1245921907
  NPD tax ID
• Legacy Healthcare Services Inc

  • Physical Therapist
  • Knoxville, TN
  • NPI 1306454558
  NPD tax ID

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1952995011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162815",
            "telephone_number": "910-724-7770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 ANDREW JACKSON PKWY",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370762270",
            "telephone_number": "855-289-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HEALTHCARE SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "GIL",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "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": []
}

• Donald J. Lazas Jr., MD
• Abalonia Rose Leavitt, CD, MSP, CPM, NRP
• Catherine Baker Lee, NP-C
• Gabriela Alejandra Lee, FNP-C
• Sue J Lee, MD
• Megan C Lemke, BCBA
• Leslie Lenning, MD
• Abby Lester
• Kathryn Renee Lewis, PT, DPT
• Liberty Transportation, LLC

• Physical Therapist in Hermitage, TN
• Providers in Hermitage, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.