LEGACY MEDICAL NETWORK LLC NPI 1073075438

NPI Information

NPI: 1073075438
Provider Name: LEGACY MEDICAL NETWORK LLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 36D2168447

Address:
5797 BEECHCROFT RD STE F
COLUMBUS, OH
ZIP 43229
Phone: (614) 377-0268
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LEGACY MEDICAL NETWORK LLC is a family nurse practitioner in Columbus, OH. LEGACY MEDICAL NETWORK LLC NPI is 1073075438. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5797 BEECHCROFT RD STE F
COLUMBUS, OH
ZIP 43229-758
Phone: (614) 377-0268

The provider's authorized official is Joseph Konika .
The authorized official title is President and has the following contact phone number (614) 458-8283.

The CLIA number assigned to this NPI record is 36D2168447 - other practitioner with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/4/2019 and was last updated on 6/11/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	163W00000X	Registered Nurse		No
2	261Q00000X	Clinic/Center		No
3	261QH0100X	Clinic/Center	Health Service	No
4	261QP2300X	Clinic/Center	Primary Care	No
5	261QS1000X	Clinic/Center	Student Health	No
6	261QU0200X	Clinic/Center	Urgent Care	No
7	363L00000X	Nurse Practitioner		No
8	363LF0000X	Nurse Practitioner	Family	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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