Legacy Medical Llc - Medicare Primary Care in Bismarck, ND

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Legacy Medical Llc is a medicare enrolled primary clinic (Family Medicine - Adult Medicine) in Bismarck, North Dakota. The current practice location for Legacy Medical Llc is 600 S 2nd St Ste 200, Bismarck, North Dakota. For appointments, you can reach them via phone at (701) 516-4637. The mailing address for Legacy Medical Llc is Po Box 13238, Grand Forks, North Dakota and phone number is (701) 516-4637.

Legacy Medical Llc is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1619594637. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (701) 516-4637.

Contact Information

Legacy Medical Llc
600 S 2nd St Ste 200
Bismarck
ND 58504-5729
(701) 516-4637
(877) 651-1381

Map and Direction


Primary Care Clinic Profile

Full NameLegacy Medical Llc
SpecialityFamily Medicine
Location600 S 2nd St Ste 200, Bismarck, North Dakota
Authorized Official Name and PositionJill Wilson (CHIEF OPERATING OFFICER)
Authorized Official Contact7015164637
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Legacy Medical Llc
Po Box 13238
Grand Forks
ND 58208-3238

Ph: (701) 516-4637		Legacy Medical Llc
600 S 2nd St Ste 200
Bismarck
ND 58504-5729

Ph: (701) 516-4637

NPI Details:

NPI Number1619594637
Provider Enumeration Date06/26/2020
Last Update Date03/03/2023

Medicare PECOS Information:

Medicare PECOS PAC ID0648698290
Medicare Enrollment IDO20200914001248

Medical Identifiers

Medical identifiers for Legacy Medical Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619594637NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207QA0505XFamily Medicine - Adult Medicine (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Legacy Medical Llc acts as a billing entity for following providers:
Provider NameRebecca Kreis
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1164775441
PECOS PAC ID: 9335392232
Enrollment ID: I20121228000308
Provider NameCynthia L Wald
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1912498593
PECOS PAC ID: 7719237932
Enrollment ID: I20180910003123
Provider NameChelsea Vollmer
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1871154211
PECOS PAC ID: 9739418435
Enrollment ID: I20190905001406
Provider NameTricia Brown
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1073974168
PECOS PAC ID: 1456770395
Enrollment ID: I20200928000532
Provider NameShannon Feist
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1942897491
PECOS PAC ID: 0547660268
Enrollment ID: I20210616002609
Provider NameMichelle Jill Rexine
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1598413312
PECOS PAC ID: 4486040946
Enrollment ID: I20220408002035
Provider NameKaitlyn Marie Perez
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1740919224
PECOS PAC ID: 4587045885
Enrollment ID: I20220718003080
Provider NameMallorie Emory
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1396484952
PECOS PAC ID: 2567843592
Enrollment ID: I20220721001823
Provider NameSavannah Rose Smith
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1306558739
PECOS PAC ID: 1254797632
Enrollment ID: I20230510002573
Provider NameTraci Specht
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1144908625
PECOS PAC ID: 0648631622
Enrollment ID: I20230808000181
Provider NameAndrea Marie Jorgenson
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1326810177
PECOS PAC ID: 0345692216
Enrollment ID: I20240116002736
Provider NameRussell James Niffenegger
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1659154706
PECOS PAC ID: 9931543626
Enrollment ID: I20240221002623
Provider NameTiffany Lynn Rhein
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215792973
PECOS PAC ID: 8527409721
Enrollment ID: I20240517001971
Provider NameChristina Rose Walker
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1215431853
PECOS PAC ID: 8628326618
Enrollment ID: I20240708003454
Provider NameAnna Rose Wiemken
Provider TypePractitioner - Nurse Practitioner
Provider IdentifiersNPI Number: 1982433082
PECOS PAC ID: 3971034257
Enrollment ID: I20240927002228
Provider NameJeffrey Rapp
Provider TypePractitioner - Family Practice
Provider IdentifiersNPI Number: 1386612653
PECOS PAC ID: 4789655267
Enrollment ID: I20241018002485

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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.