LEGACY HOME HEALTH LLC (NPI# 1841700184) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841700184 |
| Entity Type | Organization |
| Organization Name | LEGACY HOME HEALTH LLC |
| Practice Address |
970 Lake Carillon Dr Ste 300 St Petersburg FL 33716-1130 |
| Practice Telephone | 3037174336 |
| Enumeration Date | 2017-09-30 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | ROLAND VAUGHN (PRESIDENT) |
| Authorized Official Telephone | 3037174336 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 37562 | 05 |
| Street Address |
970 LAKE CARILLON DR STE 300 |
| City | ST PETERSBURG |
| State | FL |
| Zip Code | 33716-1130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093224388 | Roland Vaughn | Military Health Care Provider | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2017-09-29 |
| 1689217747 | True North Health Navigation LLC | Emergency Medicine | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2019-10-22 |
| 1679057632 | Dispatchhealth-florida Pa | Emergency Medicine | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2018-09-17 |
| 1619475290 | Lucid Genetics, Corp. | Clinic/Center | 970 Lake Carillon Dr Ste 300, St Petersburg, FL 33716-1130 | 2018-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699205815 | Orthopaedic Medical Group of Tampa Bay Pa | Clinic/Center | 10033 Mlk Jr St N Fl 3, St Petersburg, FL 33716 | 2017-06-20 |
| 1316471113 | Sara Alexandra Maltese | Dentist | 871 Ibis Walk Pl N Unit 7201, St Petersburg, FL 33716 | 2017-04-18 |
| 1508229972 | Florida Cardiac Therapeutics, Inc | Internal Medicine | 10033 Doctor M.l.k. Jr St N, Suite 302, St Petersburg, FL 33716 | 2016-04-01 |
| 1720440902 | Valorie Baker | Day Training, Developmentally Disabled Services | 115 112th Ave Ne Apt 627, St Petersburg, FL 33716 | 2016-03-25 |
| 1346611142 | Theresa Bowen | Occupational Therapist | 810 S. Village Drive N, #103, St. Petersburg, FL 33716 | 2015-10-19 |
| 1356775423 | Paula J Smith | Massage Therapist | 400 Carillon Pkwy #130, Mountain Tree Massage, LLC, St. Petersburg, FL 33716 | 2013-08-26 |
| 1699118596 | Kellie L Kintz | Social Worker | 540 Carillon Parkway, Apartment 3026, The Promenade At Carillon, St. Petersburg, FL 33716 | 2013-04-10 |
| 1427398288 | St. Petersburg General Hospital | General Acute Care Hospital | 11850 Doctor Martin Luther King Jr. St. North, Apt 22-312, St Petersburg, FL 33716 | 2013-02-15 |
| 1952657314 | Trudy Anna Glover | Occupational Therapy Assistant | 11850 9th Street North, Apt 20208, St Petersburg, FL 33716 | 2012-08-02 |
| 1275834129 | Prison Rehabilitative Industries & Diversified Enterprises | Dental Laboratory | 12425 28th St. N., Suite 300, St. Petersburg, FL 33716 | 2010-11-09 |
| Find all providers in zip 33716 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174135727 | K2d3 Enterprise LLC | Home Health | 5959 Central Ave Ste 403, St Petersburg, FL 33710-8502 | 2020-08-17 |
| 1073121471 | Aloe At Home LLC | Home Health | 835 Newton Ave S, St Petersburg, FL 33701-5325 | 2020-07-21 |
| 1144842162 | Jilliann Rae Lunn | Home Health | 3520 56th Ave N, St Petersburg, FL 33714-1849 | 2020-05-13 |
| 1376175208 | David Phandara | Home Health | 3031 14th St N, St Petersburg, FL 33704-1914 | 2020-02-09 |
| 1659923472 | Covenant Home Health Care 5, LLC | Home Health | 2546 22nd Ave N, St Petersburg, FL 33713-4311 | 2019-07-11 |
| 1407415839 | Helping Hands Priority Home Care Services, Inc | Home Health | 295 15th St N, St Petersburg, FL 33705-2013 | 2019-06-10 |
| 1730646605 | Gulf Breeze Home Health, Inc. | Home Health | 111 2nd Ave N Ste 355, St Petersburg, FL 33701-3315 | 2019-02-26 |
| 1518424910 | Florida Homecare Specialists Minority Corp | Home Health | 1211 1st Ave N. Mezzanine Ste 215, St Petersburg, FL 33705-1567 | 2019-02-22 |
| 1639633175 | Harmony Garden, LLC | Home Health | 4601 6th Ave S, St Petersburg, FL 33711-1801 | 2019-01-29 |
| 1831662022 | Provident Home Care, Inc. | Home Health | 4934 17th Ave N, St Petersburg, FL 33710-5202 | 2019-01-10 |
| Find all providers in ST PETERSBURG | ||||
| City | ST PETERSBURG |
| Zip Code | 33716 |
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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.