LEGACY MEDICAL LLC – NPI #1619594637
Family Medicine

The NUCC recommends this code not be used. Choose a more appropriate code.

Health Care Provider Taxonomy Code for Family Medicine

LEGACY MEDICAL LLC is a provider located in BISMARCK, ND. NPPES has assigned the NPI number 1619594637 to LEGACY MEDICAL LLC on June 26, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207QA0505X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adult Medicine

The NPI profile was previously updated about 3 years ago on Mar 03, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LEGACY MEDICAL LLC below.

NPI Profile for
LEGACY MEDICAL LLC

NPI Number
1619594637
Enumeration Date

(about 6 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LEGACY MEDICAL LLC
Primary location
600 S 2ND ST STE 200
BISMARCK, ND 58504-5729
Phone: (701) 516-4637 Fax: (877) 651-1381
Mailing address
PO BOX 13238
GRAND FORKS, ND 58208-3238
Phone: (701) 516-4637 Fax: (877) 651-1381
Organization Subpart
No
Authorized Official
JILL WILSON
CHIEF OPERATING OFFICER
Phone: (701) 516-4637
Updated
Certification Date
Mar 03, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0505X
- Family Medicine / Adult Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.