LEGACY PATH LLC
NPI 1205693728
Pathology - Anatomic Pathology & Clinical Pathology in South Bend, IN

Q: What is Legacy Path LLC's NPI number?

The NPI number for Legacy Path LLC is 1205693728. It was assigned to this organization in the NPPES registry on March 1, 2024.

Q: What is Legacy Path LLC's specialty?

The primary specialty registered for this NPI is Pathology, specializing in Anatomic Pathology & Clinical Pathology, with taxonomy code 207ZP0102X.

Q: When was this NPI record last updated?

The NPPES record for Legacy Path LLC was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since March 01, 2024

3355 DOUGLAS RD, SOUTH BEND, IN 46635(574) 234-4176 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 16, 2026, Jun 21, 2024, Mar 6, 2024 (3 updates tracked since 2024).

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About Legacy Path Llc NPPES

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

LEGACY PATH LLC (NPI 1205693728) is a healthcare organization registered as an anatomic pathology & clinical pathology in South Bend, Indiana and active in the NPI registry since March 2024. The organization lists Terry Pipp, Cfo, as its authorized official.

NPPES Registry Identity

NPI1205693728

Entity TypeOrganization

Primary Taxonomy207ZP0102X

Legal Business NameLEGACY PATH LLC

Location Address3355 DOUGLAS RDSouth Bend, IN 46635-1779

Mailing AddressPo Box 10961Fort Wayne, IN 46855-0961 · (800) 288-8325 · Fax (419) 866-5453

Phone(574) 234-4176

Organization SubpartNo

Authorized OfficialTerry PippCfo · (800) 288-8325

Enumeration DateMarch 1, 2024

Last NPPES UpdateJuly 16, 20263 updates tracked since enumeration

NPPES CertifiedJuly 16, 2026

✔ NPI 1205693728 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPathology · Anatomic Pathology & Clinical PathologyAllopathic & Osteopathic Physicians

Taxonomy Code207ZP0102X

Definition

A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease.

3355 DOUGLAS RD, South Bend, IN 46635

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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Legacy Path Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 21 clinicians reassign Medicare billing to Legacy Path LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 9 within 10 miles. Listed here are the 20 practicing nearest to this location.

Nearest to this location (20)

See all 21

Kristen Jacobs, M.D.

Pathology

NPI 1962594929

3355 DOUGLAS RD
South Bend, IN 46635

(574) 234-4176

✔ PECOS✔ Accepts MedicareSame address

Nicole Anest, M.D.

Pathology

NPI 1255438644

530 N. LAFAYETTE BLVD.
South Bend, IN 46601

(574) 234-4176