LEGACY INTERVENTIONAL PAIN CENTER, LLC (NPI# 1649685892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649685892 |
| Entity Type | Organization |
| Organization Name | LEGACY INTERVENTIONAL PAIN CENTER, LLC |
| Practice Address |
17051 Dallas Pkwy Ste 100 Addison TX 75001-7109 |
| Mailing Address |
Po Box 674169 Dallas TX 75267-4169 |
| Practice Telephone | 4699160521 |
| Practice Fax Number | 9722317095 |
| Mailing Telephone | 9724791115 |
| Mailing Fax Number | 9723468015 |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |
| Authorized Official Name | TRACY WALLS (MANAGER) |
| Authorized Official Telephone | 9722344740 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163W00000X | Registered Nurse | 676424 | TX | Nursing Service Providers |
| Street Address |
17051 DALLAS PKWY STE 100 |
| City | ADDISON |
| State | TX |
| Zip Code | 75001-7109 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598722654 | Andrew Eunkoo Park | Orthopaedic Surgery | 17051 Dallas Pkwy, Suite 400, Addison, TX 75001-7109 | 2006-05-01 |
| 1346774858 | Superior Anesthesia Management, LLC. | Clinic/Center | 17051 Dallas Pkwy, Suite 100, Addison, TX 75001-7109 | 2017-04-12 |
| 1790229581 | Gb Anesthesia Management | Clinic/Center | 17051 Dallas Pkwy, Suite 100, Addison, TX 75001-7109 | 2016-12-13 |
| 1164974424 | Cottonwood Anesthesia Management, LLC | Clinic/Center | 17051 Dallas Pkwy, Suite 100, Addison, TX 75001-7109 | 2016-11-02 |
| 1457808859 | U S Anesthesia Partners of Texas, Pa | Anesthesiology | 17051 Dallas Pkwy, Suite 440, Addison, TX 75001 | 2016-09-02 |
| 1174976377 | Highland Anesthia Management, LLC | Clinic/Center | 17051 Dallas Pkwy, Suite 100, Addison, TX 75001-7109 | 2016-07-22 |
| 1265885453 | Scarlet Anesthesia Management, LLC | Clinic/Center | 17051 Dallas Pkwy, Suite 100, Addison, TX 75001-7109 | 2016-07-22 |
| 1972951341 | Hawk Anesthesia Management, LLC | Clinic/Center | 17051 Dallas Pkwy, Suite 100, Addison, TX 75001-7109 | 2016-05-26 |
| 1073976684 | Glenwood Anesthesia Management | Clinic/Center | 17051 Dallas Pkwy, Suite 100, Addison, TX 75001-7109 | 2016-03-31 |
| 1093178816 | Somnium Dme | Durable Medical Equipment & Medical Supplies | 17051 Dallas Pkwy, Addison, TX 75001-7109 | 2016-03-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073143772 | Naomi Grace Moats | Speech-Language Pathologist | 5820 Addison Rd, Addison, TX 75001 | 2020-01-22 |
| 1669020467 | Us Med, LLC | Durable Medical Equipment & Medical Supplies | 15455 Dallas Parkway, Suite 600; Office #6015, Addision, TX 75001 | 2019-08-27 |
| 1316592215 | Sunny Boy Pharmacy, LLC | Pharmacy | 4388 Sunbelt Dr, Addision, TX 75001 | 2019-08-07 |
| 1538714779 | Tarpon Pllc | Physical Medicine & Rehabilitation | 17051 N. Dallas Parkway, Suite 320, Addison, TX 75001 | 2019-08-05 |
| 1235782251 | Aliah T Green | Speech-Language Pathologist | 15820 Addison Road, Addison, TX 75001 | 2019-07-18 |
| 1902376254 | Kendall Leann Chambers | Counselor | 15851 Dallas Parkway, Suite 600, Addison, TX 75001 | 2018-11-29 |
| 1053800391 | U S Anesthesia Partners of Texas, Pa | Physician Assistant | 17051 Dallas Pkwy Ste 310, Addison, TX 75001 | 2018-05-02 |
| 1528561719 | Relinda Lee Longan | Licensed Vocational Nurse | 4820 Westgrove Dr, # 903, Addison, TX 75001 | 2018-03-14 |
| 1306363338 | Margaret Weiss | Social Worker | Steven A Cohen Military Family Clinic At Metrocare, 16160 Midway Rd, Suite 218, Addison, TX 75001 | 2017-08-30 |
| 1508380759 | Dallas Sci Recovery Inc | Clinic/Center | 15046 Beltway Dr, Addison, TX 75001 | 2017-07-31 |
| Find all providers in zip 75001 | ||||
| Taxonomy Code | 163W00000X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| (1) A registered nurse is a person qualified by graduation from an accredited nursing school (depending upon schooling, a registered nurse may receive either a diploma from a hospital program, an associate degree in nursing (A.D.N.) or a Bachelor of Science degree in nursing (B.S.N.), who is licensed or certified by the state, and is practicing within the scope of that license or certification. R.N.’s assist patient in recovering and maintaining their physical or mental health. They assist physicians during treatments and examinations and administer medications. (2) A provider who is trained and educated in a formal nursing education program at an accredited school of nursing, passes a national certification examination, and is licensed by the state to practice nursing. The individual provides nursing services to patients or clients in areas such as health promotion, disease prevention, acute and chronic care and restoration and maintenance of health across the life span. |
| Notes: Sources: (2) American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue, and Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437770211 | Kristen Orvis Salter | Registered Nurse | 1218 Vt Route 17 E, Addison, VT 05491-8621 | 2020-05-03 |
| 1740756592 | Leticia Harley | Registered Nurse | 3925 Vitruvian Way Apt 2111, Addison, TX 75001-4054 | 2018-10-19 |
| 1104301928 | Viviana Lozano | Registered Nurse | 15801 Artist Way Apt 4108, Addison, TX 75001-6178 | 2018-09-27 |
| 1235611567 | Racheal Ebangha Besong | Registered Nurse | 3925 Vitruvian Way Apt 1907, Addison, TX 75001-4088 | 2018-09-04 |
| 1821592486 | Kyeongmi Kim | Registered Nurse | 3820 Vitruvian Way Apt 120, Addison, TX 75001-4433 | 2018-03-20 |
| 1912444662 | Iulia Kaulinite | Registered Nurse | 1845 East Army Trail Road, Addison, IL 60101 | 2017-01-19 |
| 1992253066 | Amy Henderson | Registered Nurse | 14131 Midway Rd Ste 260, Addison, TX 75001-3623 | 2016-09-16 |
| 1457621401 | Deborah D Bump-brown | Registered Nurse | 7 Cleveland Dr., Tuscarora Elementary School, Addison, NY 14801 | 2012-01-09 |
| 1043842651 | Guadalupe Vianey Barajas | Registered Nurse | 1111 W Lake St, Addison, IL 60101-1101 | 2020-02-11 |
| 1972144491 | Kaithynn Sanchez-guzman | Registered Nurse | 1111 W Lake St, Addison, IL 60101-1101 | 2019-10-06 |
| Find all providers in ADDISON | ||||
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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.