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LEGACY FAMILY MEDICINE LLC
NPI 1043967466
Family Medicine in West Logan, WV

Active since March 05, 2022CLIA 51D2314074 · Waiver
1113 2ND AVE, WEST LOGAN, WV 25601(304) 752-1900(304) 752-0188 Get Directions Write a Review

NPPES record last updated: September 16, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Sep 16, 2025, Feb 24, 2025, Mar 5, 2022 (3 updates tracked since 2022).

About Legacy Family Medicine Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LEGACY FAMILY MEDICINE LLC (NPI 1043967466) is a healthcare organization registered as a family medicine in West Logan, West Virginia and active in the NPI registry since March 2022. The organization holds a CLIA Waiver certificate valid through November 12, 2026 and lists Wendy White, Credentialing Specialist, as its authorized official.

NPPES Registry Identity

NPI1043967466
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLEGACY FAMILY MEDICINE LLC
Location Address1113 2ND AVEWest Logan, WV 25601-3309
Mailing Address1113 2nd AveWest Logan, WV 25601-3309 · (304) 752-1900 · Fax (304) 752-0188
Phone(304) 752-1900
Fax(304) 752-0188
Organization SubpartNo
Authorized OfficialWendy WhiteCredentialing Specialist · (304) 688-7027
Enumeration DateMarch 5, 2022
Last NPPES UpdateSeptember 16, 20253 updates tracked since enumeration
NPPES CertifiedSeptember 16, 2025
✔ NPI 1043967466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1113 2ND AVE, West Logan, WV 25601
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Other Identifiers 1

OtherAPRN66417WV · Fnp

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Highmark Blue Cross Blue Shield West Virginia.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 51D2314074

Legacy Family Medicine, LLC · West Logan, WV
Active · expires Nov 12, 2026
CLIA Number51D2314074
Laboratory TypePractitioner Other
Certificate Effective DateNovember 13, 2024
Certificate Expiration DateNovember 12, 2026
Laboratory DirectorWilliam R. Watkins
Laboratory Phone(304) 784-4995
Laboratory LocationLegacy Family Medicine, LLC1113 2nd Avenue, West Logan, WV 25601
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Legacy Family Medicine LLC's NPI number?

The NPI number for Legacy Family Medicine LLC is 1043967466. It was assigned to this organization in the NPPES registry on March 5, 2022.

Where is Legacy Family Medicine LLC located?

Legacy Family Medicine LLC is located at 1113 2nd Ave, West Logan, WV 25601. The listed phone number is (304) 752-1900.

What is Legacy Family Medicine LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Legacy Family Medicine LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 51D2314074) is associated with this NPI, valid through November 12, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Legacy Family Medicine LLC accept?

Health plans from Highmark Blue Cross Blue Shield West Virginia list Legacy Family Medicine LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Legacy Family Medicine LLC was last updated on September 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.