Active NPI
Jack Alibert Legrand Jr.
- Health Educator
- Prosperity, SC
National Provider Identifier
1982105243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Health Educator
- Practice address
- 600 N Wheeler Ave
Prosperity, SC 29127-9332 - Phone
- (803) 364-4852
- NPI assigned
- Feb 22, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Health Educator | 174H00000X | Primary |
Addresses
Primary practice location
600 N Wheeler Ave
Prosperity, SC 29127-9332
Mailing address
PO Box 630
Prosperity, SC 29127-0630
Phone (803) 364-4852
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lovelace Family Medicine, PA | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Primary Care Clinic/Center
- Prosperity, SC
- NPI 1366429987
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1519257600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1519257600000",
"number": "1982105243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 630",
"city": "PROSPERITY",
"state": "SC",
"postal_code": "291270630",
"telephone_number": "803-364-4852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "600 N WHEELER AVE",
"city": "PROSPERITY",
"state": "SC",
"postal_code": "291279332",
"telephone_number": "803-364-4852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEGRAND",
"first_name": "JACK",
"middle_name": "ALIBERT",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-02-22",
"last_updated": "2018-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "174H00000X",
"taxonomy_group": "",
"desc": "Health Educator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Prosperity, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.