| Legacy Healthcare Services, Inc. | |
|
100 Washington Commons Dr, Apt. 314, Evans, GA 30809-3159 | |
| (706) 426-8136 | |
| (706) 496-8936 |
| Full Name | Legacy Healthcare Services, Inc. |
|---|---|
| Type | Facility |
| Speciality | Occupational Therapist |
| Location | 100 Washington Commons Dr, Evans, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528419751 | NPI | - | NPPES |
| Provider Name | Nina A Grandin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588739056 PECOS PAC ID: 8921016585 Enrollment ID: I20060323000764 |
| Provider Name | Jennifer Vistnes |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1730242926 PECOS PAC ID: 6507044401 Enrollment ID: I20110623000649 |
| Provider Name | Deanna K Brubaker |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194896076 PECOS PAC ID: 6305083718 Enrollment ID: I20130502000184 |
| Provider Name | Erika C Linstrom |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114159498 PECOS PAC ID: 4688729973 Enrollment ID: I20131125000825 |
| Provider Name | Patricio Morchio |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1558741207 PECOS PAC ID: 6901114917 Enrollment ID: I20150924001205 |
| Provider Name | Keitoria Lacount |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1356561096 PECOS PAC ID: 9537460803 Enrollment ID: I20151211000802 |
| Provider Name | Neelam K Patel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1346616570 PECOS PAC ID: 4284935370 Enrollment ID: I20151215000156 |
| Provider Name | Christopher Andrew Carter |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1982058863 PECOS PAC ID: 1557654274 Enrollment ID: I20160718002290 |
| Provider Name | Cheries L Brule |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1467420661 PECOS PAC ID: 3678698479 Enrollment ID: I20160809002099 |
| Provider Name | Kelly A Williams Wyche |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1174729263 PECOS PAC ID: 3476839358 Enrollment ID: I20170406002694 |
| Provider Name | Samuel O Wehby |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104219914 PECOS PAC ID: 7719263979 Enrollment ID: I20170425000189 |
| Provider Name | Susanna Grace Krouse |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700301975 PECOS PAC ID: 1153696364 Enrollment ID: I20171013000281 |
| Provider Name | Cherie Dempster |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699084053 PECOS PAC ID: 4789944182 Enrollment ID: I20180202001899 |
| Provider Name | Karen M Pama |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1730473455 PECOS PAC ID: 8022372580 Enrollment ID: I20180509000672 |
| Provider Name | Lora Marie C Reed |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1831435122 PECOS PAC ID: 3577708346 Enrollment ID: I20180521000379 |
| Provider Name | Andrea Mcmahan |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1417447459 PECOS PAC ID: 4880942374 Enrollment ID: I20180820000917 |
| Provider Name | Charla N Nelson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1689639924 PECOS PAC ID: 8820184351 Enrollment ID: I20181022003390 |
| Provider Name | Lindsay Lively |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1629564968 PECOS PAC ID: 6901139989 Enrollment ID: I20190605003222 |
| Provider Name | Emily Patton |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427514272 PECOS PAC ID: 2264867936 Enrollment ID: I20200128000263 |
| Provider Name | Meredith Stokes |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376741694 PECOS PAC ID: 1355779307 Enrollment ID: I20200325001705 |
| Provider Name | Kelly M West |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1285299883 PECOS PAC ID: 4486083581 Enrollment ID: I20200409003336 |
| Provider Name | Karen M Durden |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1396833802 PECOS PAC ID: 9436589538 Enrollment ID: I20200413002139 |
| Provider Name | John Forrest Nettles |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1932761756 PECOS PAC ID: 5395630032 Enrollment ID: I20200630001997 |
| Provider Name | Cheryl Willis |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1093722407 PECOS PAC ID: 9739506809 Enrollment ID: I20200903001831 |
| Provider Name | Glenn L Johlman |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1598037962 PECOS PAC ID: 4880855360 Enrollment ID: I20201007002053 |
| Provider Name | Lisa Carr |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1679169346 PECOS PAC ID: 3072928811 Enrollment ID: I20210209001359 |
| Provider Name | Meghan Rardin |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1588834832 PECOS PAC ID: 2668602160 Enrollment ID: I20210222001681 |
| Provider Name | Abigael C Panares |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336606730 PECOS PAC ID: 5799192258 Enrollment ID: I20210329002144 |
| Provider Name | Bonnie J Young |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1699089912 PECOS PAC ID: 8224432927 Enrollment ID: I20210803000919 |
| Provider Name | Julie Kierstein |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083808083 PECOS PAC ID: 8729483185 Enrollment ID: I20210823002411 |
| Provider Name | Chelsea Underwood |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1649897901 PECOS PAC ID: 7517385024 Enrollment ID: I20211103002616 |
| Provider Name | Michael S Shadburn |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1306429618 PECOS PAC ID: 8325430143 Enrollment ID: I20220127002003 |
| Provider Name | Kristen M Finlay |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114683166 PECOS PAC ID: 2668865312 Enrollment ID: I20220202000911 |
| Provider Name | Courtney Lynn Hodgeman |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1649790767 PECOS PAC ID: 0244500320 Enrollment ID: I20220228001041 |
| Provider Name | Caleb M Fairey |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518306034 PECOS PAC ID: 5395987218 Enrollment ID: I20220527000822 |
| Provider Name | Mitzie Marion C Mickelson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1801408802 PECOS PAC ID: 8123408721 Enrollment ID: I20220629000076 |
| Provider Name | Laura Jackson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1457844110 PECOS PAC ID: 6800273798 Enrollment ID: I20220725000631 |
| Provider Name | Kristy K Grayson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1003238460 PECOS PAC ID: 3173908282 Enrollment ID: I20220909001506 |
| Provider Name | Jemicah N Mosby |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1194480764 PECOS PAC ID: 8729464110 Enrollment ID: I20221010000420 |
| Provider Name | Khadesha Quammie |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1316662992 PECOS PAC ID: 7214303353 Enrollment ID: I20221014001604 |
| Provider Name | Kailey L Mccarty |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1558734863 PECOS PAC ID: 4385009406 Enrollment ID: I20230425001298 |
| Provider Name | Steven P Craig |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1437859725 PECOS PAC ID: 3678938446 Enrollment ID: I20230501000475 |
| Provider Name | Jade L Matthews-rosado |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1609578640 PECOS PAC ID: 8123483559 Enrollment ID: I20230516003050 |
| Provider Name | Shyrece D Celestine |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1487364428 PECOS PAC ID: 6608232475 Enrollment ID: I20230522000013 |
| Provider Name | Shontae D Davis |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1861047953 PECOS PAC ID: 2961869482 Enrollment ID: I20230526002015 |
| Provider Name | Jessica R Quiles |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1114325545 PECOS PAC ID: 2668839812 Enrollment ID: I20230605000883 |
| Provider Name | Brenda L Williams |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1972976140 PECOS PAC ID: 9537439005 Enrollment ID: I20230613000597 |
| Provider Name | Jessica N Vick |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427789171 PECOS PAC ID: 9638537251 Enrollment ID: I20230614000648 |
| Provider Name | Mia Marrow |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1700574126 PECOS PAC ID: 0446610612 Enrollment ID: I20230719002640 |
| Provider Name | Heather M Tabor |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1275833808 PECOS PAC ID: 7810358629 Enrollment ID: I20230726002112 |
| Provider Name | Mykiah Clark |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1740944388 PECOS PAC ID: 2769846609 Enrollment ID: I20230912001084 |
| Provider Name | Camille Alline Clancy |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1124429741 PECOS PAC ID: 9830553379 Enrollment ID: I20230915002780 |
| Provider Name | Kim Khong |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1083499222 PECOS PAC ID: 4880048628 Enrollment ID: I20230927001285 |
| Provider Name | Shannon Alexandra Stanley |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1326530098 PECOS PAC ID: 8325493513 Enrollment ID: I20231007000735 |
| Provider Name | Sherise Hextall |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1710587266 PECOS PAC ID: 7416350715 Enrollment ID: I20231017002602 |
| Provider Name | Natalie Paige Brown |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1760110332 PECOS PAC ID: 1254787450 Enrollment ID: I20231024003473 |
| Provider Name | Angela Renee Wilson |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1750048658 PECOS PAC ID: 4688020282 Enrollment ID: I20231101003024 |
| Provider Name | Lauren Ashley Shields |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1932616877 PECOS PAC ID: 0042667115 Enrollment ID: I20231110001337 |
| Provider Name | Ashley P Wilson |
|---|---|
| Provider Type | Practitioner - Occupational Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1376314369 PECOS PAC ID: 0446694723 Enrollment ID: I20240214001983 |
| Provider Name | James Barrett Cole |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1831956275 PECOS PAC ID: 2466890447 Enrollment ID: I20240410001016 |
| Provider Name | Brian Tye |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1871190561 PECOS PAC ID: 6901246131 Enrollment ID: I20240503002857 |
| Provider Name | Alexandra Ruello |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1184474439 PECOS PAC ID: 9335581784 Enrollment ID: I20240530002052 |
| Provider Name | Krista Rae Wagenknecht |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1518525047 PECOS PAC ID: 4688116924 Enrollment ID: I20240603001252 |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Healthcare Services, Inc. 110 Horizon Dr Ste 310, Raleigh, NC 27615-4926 Ph: (919) 424-5080 | Legacy Healthcare Services, Inc. 100 Washington Commons Dr, Apt. 314, Evans, GA 30809-3159 Ph: (706) 426-8136 |
Mrs. Lillian Nicole Brewer, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 4130 Fox Brush Dr, Evans, GA 30809 Phone: 706-825-9966 | |
Melissa W Fitzgerald, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 446 Northridge Cir, Evans, GA 30809 Phone: 706-210-0282 Fax: 706-210-0282 | |
Annlen Marie Zorn, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 536 Grand Slam Dr Ste D, Evans, GA 30809 Phone: 706-842-3330 | |
Melinda L Coleman, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 815 Walden Glen Ln, Evans, GA 30809 Phone: 706-495-2528 Fax: 706-364-0351 | |
Sherry Brown, OT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 536 Grand Slam Dr, Suite D, Evans, GA 30809 Phone: 706-854-8434 Fax: 706-854-8435 | |
Mrs. Nancy Lynn Clements-morgan, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 5086 Wells Dr, Evans, GA 30809 Phone: 706-650-1344 | |
Bailey Olivia Parker, OT, MOT Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 4446 Washington Rd Ste 8, Evans, GA 30809 Phone: 706-869-3352 Fax: 706-869-3299 |