LEGACY HEALTHCARE SERVICES (NPI# 1043580129) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043580129 |
| Entity Type | Organization |
| Organization Name | LEGACY HEALTHCARE SERVICES |
| Practice Address |
5114 Providence Rd Charlotte NC 28226-5852 |
| Mailing Address |
4626 Colony Road Apt I Charlotte NC 28226-4980 |
| Practice Telephone | 7043655252 |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2012-01-06 |
| Authorized Official Name | JACQUELINE TRILL (OCCUPATIONAL THERAPIST) |
| Authorized Official Telephone | 7168075074 |
| Authorized Official Credential | MS,OTR/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225X00000X | Occupational Therapist | 7683 | NC | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720483738 | Legacy Healthcare Services | Assisted Living Facility | 5327 S Jellison St, Littleton, CO 80123-2185 | 2014-11-03 |
| 1215269485 | Legacy Healthcare Services | Home Health | 10135 Glengate Ln, Houston, TX 77036-8607 | 2010-02-12 |
| 1699131573 | Legacy Healthcare Services | Clinic/Center | 15822 Clayton Rd, Ellisville, MO 63011-2212 | 2016-01-08 |
| 1063806784 | Legacy Healthcare Services | Skilled Nursing Facility | 3100 Spring Forest Rd, Raleigh, NC 27616-2880 | 2015-03-19 |
| 1922496926 | Legacy Healthcare Services | Assisted Living Facility | 28 Lincoln St, Hudson Falls, NY 12839-2431 | 2014-12-30 |
| 1831523570 | Legacy Healthcare Services | Physical Therapy Assistant | 111 Harrilson Rd, Cherryville, NC 28021-9541 | 2013-08-29 |
| 1942647524 | Legacy Healthcare Services | Assisted Living Facility | 1950 S Dayton St, Denver, CO 80247-3452 | 2013-05-23 |
| 1003113499 | Legacy Healthcare Services | Clinic/Center | 750 Se Cary Pkwy, Cary, NC 27511-5682 | 2011-02-21 |
| 1265749535 | Legacy Healthcare Services | Health Maintenance Organization | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2010-09-08 |
| 1912228735 | Legacy Healthcare Services | Clinic/Center | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2010-06-15 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| North Carolina Corporations | LEGACY HEALTHCARE SERVICES INC. | 176 Mine Lake Court Ste. 100, Raleigh, NC 27615-6417 |
| Virginia Business Entities | Legacy HealthCare Services Inc. | 3001 Spring Forest Rd, Raleigh, North Carolina 27616 |
| Connecticut Business Registrations | LEGACY HEALTHCARE SERVICES, INC. | 164 Wind Chime Court, Raleigh, NC 27615 |
| Iowa Business Entities | LEGACY HEALTHCARE SERVICES, INC. | 3001 Spring Forest Rd., Raleigh, NC 27616 |
| Colorado Business Entities | LEGACY HEALTHCARE SERVICES, INC. | 3001 Spring Forest Road, Raleigh, NC 27616 |
| Street Address |
5114 PROVIDENCE RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28226-5852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447466297 | Cassandra Testa | Physical Therapy Assistant | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2007-05-15 |
| 1760947055 | Joseph Rodriguez | Physical Therapist | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2019-01-31 |
| 1396114344 | Michelle Florio Maitin | Speech-Language Pathologist | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2015-09-21 |
| 1639411721 | Al One Investments LLC | Assisted Living Facility | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2013-03-27 |
| 1376807800 | Nicholas James Brand | Occupational Therapist | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2012-06-29 |
| 1942510490 | Angela Nichole Sawyer | Occupational Therapy Assistant | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2010-10-18 |
| 1265749535 | Legacy Healthcare Services | Health Maintenance Organization | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2010-09-08 |
| 1487975686 | Patti Burris Deaton | Occupational Therapy Assistant | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2010-06-22 |
| 1912228735 | Legacy Healthcare Services | Clinic/Center | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2010-06-15 |
| 1730414608 | Tara Tennison Fitzgerald | Physical Therapist | 5114 Providence Rd, Charlotte, NC 28226-5852 | 2009-10-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841837507 | Southeast Vulvar Clinic, Pllc | Dermatology | 6406 Carmel Road, Suite 309, Charlotte, NC 28226 | 2019-12-02 |
| 1427540012 | Kenneth William Riley Jr. | Behavioral Analyst | 10953 Park Rd., Charlotte, NC 28226 | 2018-05-31 |
| 1780103838 | Tamara Andres | Specialist/Technologist | 2518 Lawton Bluff Rd., Charlotte, NC 28226 | 2017-09-10 |
| 1083132609 | Xenon Anesthesia of North Carolina Pllc | Anesthesiology | 7006 Shannon Willow Road, Charlotte, NC 28226 | 2017-09-04 |
| 1104354117 | Lauren Nicole Brindisi | Chiropractor | 11230 Carmel Commons Blvd., Charlotte, NC 28226 | 2017-06-03 |
| 1346790821 | Carolinas Skin Center Pa | Plastic Surgery | 3315 Springbank Lane, Suite 202, Charlotte, NC 28226 | 2016-10-10 |
| 1871040469 | Julie R Jackson | Counselor | 7810 Prineville-mathews Road, Charlotte, NC 28226 | 2016-09-01 |
| 1518346105 | Christopher Abernathy | Dentist | 3111 Springbank Ln Ste A, Charlotte, NC 28226 | 2015-05-28 |
| 1285067504 | Amy N Bullock | Physical Therapist | 7207 Marcel Ln Apt 1138, Charlotte, NC 28226 | 2013-08-11 |
| 1528405297 | Elevate Counseling and Clinical Services, Pllc | Community/Behavioral Health | 107220 Carmel Commons Blvd., Ste. 320, Charlotte, NC 28226 | 2013-06-04 |
| Find all providers in zip 28226 | ||||
| Taxonomy Code | 225X00000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Occupational Therapist |
| An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life. |
| Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588279863 | Jessica Laser | Occupational Therapist | 8819 Norway Ct, Charlotte, NC 28269-5180 | 2020-09-13 |
| 1700424397 | Elizabeth Gendernalik | Occupational Therapist | 1027 Healthcare Dr, Charlotte, MI 48813-1056 | 2019-12-15 |
| 1598302937 | Brigit Boyce | Occupational Therapist | 8848 Red Oak Blvd, Ste Aa, Charlotte, NC 28217 | 2019-12-04 |
| 1144865734 | Darci Pernoud | Occupational Therapist | 13000 S Tryon St Ste F-349, Charlotte, NC 28278-7652 | 2019-11-07 |
| 1619527199 | Paige Nicole Chester | Occupational Therapist | 206 Livingstone Falls Dr Apt 212, Charlotte, NC 28217-5247 | 2019-09-16 |
| 1528628823 | Happy Kids Therapy | Occupational Therapist | 11012 Knight Castle Dr, Charlotte, NC 28277-0212 | 2019-06-18 |
| 1861957235 | Rachel Floren Payne | Occupational Therapist | 2142 Commonwealth Ave Apt 423, Charlotte, NC 28205-5177 | 2019-02-09 |
| 1497234611 | Benchmark Physical Therapy of Nc, LLC | Occupational Therapist | 16139 Lancaster Hwy Ste 140, Charlotte, NC 28277-2033 | 2018-08-08 |
| 1023520558 | Brittany Stanton | Occupational Therapist | 2301 Crownpoint Executive Dr Ste 3, Charlotte, NC 28227-7824 | 2017-10-24 |
| 1871016816 | Monarch | Occupational Therapist | 1810 Back Creek Drive, Charlotte, NC 28213 | 2017-07-21 |
| Find all providers in CHARLOTTE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.