LEGACY MEDICAL GROUP, LLC (NPI# 1447621685) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447621685 |
| Entity Type | Organization |
| Organization Name | LEGACY MEDICAL GROUP, LLC |
| Practice Address |
1020 W Atherton Dr Suite 220 Taylorsville UT 84123-3470 |
| Practice Telephone | 8018330000 |
| Practice Fax Number | 8018330001 |
| Mailing Telephone | 8018330000 |
| Mailing Fax Number | 8018330001 |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2015-11-09 |
| Authorized Official Name | KRISTINA MOSLEY-CARTER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 8018330000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1020 W ATHERTON DR SUITE 220 |
| City | TAYLORSVILLE |
| State | UT |
| Zip Code | 84123-3470 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679186837 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 5792 South Redwood Road, Taylorsville, UT 84123 | 2020-08-27 |
| 1164040614 | Mark E Hutchinson | Counselor | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1396259321 | Utah Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 4082 South Redwood Road, West Valley Road, UT 84123 | 2017-11-29 |
| 1083131890 | Kelli Mcstotts | Counselor | 5689 S. Redwood Road, Taylorsville, UT 84123 | 2017-08-23 |
| 1740706571 | Laura B Ellsworth | Case Manager/Care Coordinator | 5667 So. Redwood Road, 6b, Salt Lake City, UT 84123 | 2017-08-14 |
| 1790214120 | Integrated Autism Therapies | Behavioral Analyst | 5984 S. Susquehanna, Murray, UT 84123 | 2017-06-08 |
| 1083163885 | Michael John Flint | Counselor | 5861 South Redwood Road, #24, Taylorsville, UT 84123 | 2016-09-22 |
| 1548716236 | Andres Ramos | Licensed Psychiatric Technician | 697 West 4170 South, Murray, UT 84123 | 2016-09-01 |
| 1467807040 | Sheryl R Schindler | Counselor | 5770 South 1550 West, Bldg G, Primary Children's Counseling Center, Taylorsville, UT 84123 | 2016-05-02 |
| 1730562141 | Megan Merica Snarr | Dentist | 597 West 5300 South, Murray, UT 84123 | 2015-07-02 |
| Find all providers in zip 84123 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770078842 | Kelly Bryan Gines | Nurse Practitioner | 6321 S Redwood Rd Ste 201, Taylorsville, UT 84123-6972 | 2018-06-29 |
| 1396270021 | Susan Cooper | Nurse Practitioner | 5360 S 2700 W, Taylorsville, UT 84129-1524 | 2017-05-01 |
| 1164521548 | Sharon L Scruggs | Nurse Practitioner | 336 Eureka Street, Taylorsville, MS 39168-0291 | 2006-09-21 |
| 1912015298 | Carolyn Ann Schrader | Nurse Practitioner | 409 Willis Street, Suite 2, Taylorsville, MS 39168 | 2006-08-28 |
| 1720574718 | Stephanie Marie Valeri | Nurse Practitioner | 3809 W 6200 S, Taylorsville, UT 84129-3725 | 2018-07-02 |
| 1235629171 | Stacey Marie Land | Nurse Practitioner | 220 Hills Creek Rd, Taylorsville, GA 30178-2068 | 2018-05-16 |
| 1750707535 | Betsy Ann Ramey | Nurse Practitioner | 83 W Main St, Taylorsville, KY 40071-8616 | 2014-03-17 |
| 1518380344 | Joy Duckworth | Nurse Practitioner | 50 Macedonia Church Rd, Suite A, Taylorsville, NC 28681-8414 | 2014-01-30 |
| 1972892396 | Georgia Talula Allen | Nurse Practitioner | 5770 S 1500 W, Taylorsville, UT 84123-5216 | 2011-04-06 |
| 1003114604 | Lauren Bramlett Horn | Nurse Practitioner | 97 Church St, Taylorsville, GA 30178-1902 | 2011-03-05 |
| Find all providers in TAYLORSVILLE | ||||
| City | TAYLORSVILLE |
| Zip Code | 84123 |
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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.