Mr Fred Vaughan Legg Iii, is a medicare enrolled "Nurse Practitioner - Family" in Sautee, Georgia. His current practice location is
310 Black Bear Ridge Rd, Black Bear Treatment Center, Sautee, Georgia. You can reach out to his office (for appointments etc.) via phone at
(470) 539-6905.
Mr Fred Vaughan Legg Iii is licensed to practice in Georgia (license number RN117118) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1346791878.
Provider's Profile
| Full Name | Mr Fred Vaughan Legg Iii |
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| Gender | Male |
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| Speciality | Nurse Practitioner - Family |
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| Location | 310 Black Bear Ridge Rd, Sautee, Georgia |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1346791878
- Provider Enumeration Date: 10/19/2016
- Last Update Date: 10/19/2016
Medicare PECOS Information:
- PECOS PAC ID: 2769747393
- Enrollment ID: I20180531000429
Medical Identifiers
Medical identifiers for Mr Fred Vaughan Legg Iii such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1346791878 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363LF0000X | Nurse Practitioner - Family | RN117118 (Georgia) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mr Fred Vaughan Legg Iii allows following entities to bill medicare on his behalf.
| Entity Name | Privia Medical Group Of Georgia Llc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1013313857
PECOS PAC ID: 4284951542
Enrollment ID: O20150325000983 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Fred Vaughan Legg Iii is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Mr Fred Vaughan Legg Iii,
310 Black Bear Ridge Rd, Black Bear Treatment Center,
Sautee, GA 30571
Ph: (470) 539-6905 | Mr Fred Vaughan Legg Iii,
310 Black Bear Ridge Rd, Black Bear Treatment Center,
Sautee, GA 30571
Ph: (470) 539-6905 |
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