NPIMap

Organization Active NPI

Legacy

  • Nursing Facility/Intermediate Care Facility
  • Raleigh, NC
National Provider Identifier
1992115406
Registry record updated May 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
5760 Issued in NC
Legal business name
LEGACY
Practice address
3001 Spring Forest Rd
Raleigh, NC 27616-2815
Phone
(919) 424-5086
Fax
(919) 424-5085
NPI assigned
May 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 6, 2014

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

Authorized official

Name
Bonnie Faye Hummer-Wheeler, COTA
Title
Certified Occupational Therapist
Phone
(910) 964-4764

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 5760 NC Primary

Addresses

Primary practice location

3001 Spring Forest Rd
Raleigh, NC 27616-2815

Mailing address

3001Spring Forest Road
Raliegh, NC 27616
Phone (919) 424-5086

Other identifiers 1

IdentifierTypeStateIssuer
25000000MedicaidNC

National Provider Directory

National Provider Directory
Tax ID family
Legacy61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 12

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

NPI Registry JSON

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

{
    "created_epoch": "1399334400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399334400000",
    "number": "1992115406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001SPRING FOREST ROAD",
            "city": "RALIEGH",
            "state": "NC",
            "postal_code": "27616",
            "telephone_number": "919-424-5086",
            "fax_number": "919-424-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 SPRING FOREST RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162815",
            "telephone_number": "919-424-5086",
            "fax_number": "919-424-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-06",
        "last_updated": "2014-05-06",
        "status": "A",
        "authorized_official_last_name": "HUMMER-WHEELER",
        "authorized_official_first_name": "BONNIE",
        "authorized_official_middle_name": "FAYE",
        "authorized_official_title_or_position": "CERTIFIED OCCUPATIONAL THERAPIST",
        "authorized_official_telephone_number": "910-964-4764",
        "authorized_official_credential": "COTA"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "NC",
            "license": "5760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25000000",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2014; 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.