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LEGACY FAMILY MEDICINE LLC
NPI 1265172399
Family Medicine in Gallup, NM

Active since March 29, 2022
1808 E AZTEC AVE STE 6, GALLUP, NM 87301(505) 863-9374 Get Directions Write a Review

NPPES record last updated: March 29, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Legacy Family Medicine Llc NPPES

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

LEGACY FAMILY MEDICINE LLC (NPI 1265172399) is a healthcare organization registered as a family medicine in Gallup, New Mexico and active in the NPI registry since March 2022. The organization lists Brett Hartline, Administrator, as its authorized official.

NPPES Registry Identity

NPI1265172399
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLEGACY FAMILY MEDICINE LLC
Location Address1808 E AZTEC AVE STE 6Gallup, NM 87301-4946
Mailing AddressPo Box 402Lupton, AZ 86508-1402
Phone(505) 863-9374
Organization SubpartNo
Authorized OfficialBrett HartlineAdministrator · (480) 498-9086
Enumeration DateMarch 29, 2022
NPPES CertifiedMarch 29, 2022
✔ NPI 1265172399 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.
1808 E AZTEC AVE STE 6, Gallup, NM 87301
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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

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MESKEE LYNN TSOTADDLE-YATSAYTE CCHW
Community Health Worker
1808 E AZTEC AVE STE 6
GALLUP, NM 87301
McKinley County (505) 405-9440
DAVID MCKENZIE MD PC
Family Medicine
1808 E AZTEC AVE STE 6
GALLUP, NM 87301
McKinley County (505) 863-9374
SANTA FE RECOVERY CENTER
Substance Abuse Rehabilitation Facility
1808 E AZTEC AVE STE 6
GALLUP, NM 87301
McKinley County (505) 413-3447
JERRY JAMES ORR CCSS
Community Health Worker
1808 E AZTEC AVE STE 6
GALLUP, NM 87301
McKinley County (505) 870-9812

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 1265172399. It was assigned to this organization in the NPPES registry on March 29, 2022.

Where is Legacy Family Medicine LLC located?

Legacy Family Medicine LLC is located at 1808 E Aztec Ave Ste 6, Gallup, NM 87301. The listed phone number is (505) 863-9374.

What is Legacy Family Medicine LLC's specialty?

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

When was this NPI record last updated?

The NPPES record for Legacy Family Medicine LLC was last updated on March 29, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.