LEGACY PRIMARY CARE PLLC
NPI 1265277115
Family Medicine - Adult Medicine in Grand Forks, ND
About Legacy Primary Care Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LEGACY PRIMARY CARE PLLC (NPI 1265277115) is a healthcare organization registered as an adult medicine in Grand Forks, North Dakota and active in the NPI registry since July 2024. The organization lists Heidi Williams, Cred Spec, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Accepted Insurance
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 Primary Care Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
22Medicare enrollment records show 22 clinicians reassign Medicare billing to Legacy Primary Care PLLC, which bills Medicare for the services they deliver. Of these, 3 practice at this address. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 2
Nearest to this location (20)
See all 22Cloquet, MN 55720
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 Primary Care PLLC's NPI number?
The NPI number for Legacy Primary Care PLLC is 1265277115. It was assigned to this organization in the NPPES registry on July 1, 2024.
Where is Legacy Primary Care PLLC located?
Legacy Primary Care PLLC is located at 2100 S Columbia Rd Ste 114, Grand Forks, ND 58201. The listed phone number is (701) 516-4637.
What is Legacy Primary Care PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine, specializing in Adult Medicine, with taxonomy code 207QA0505X.
Is Legacy Primary Care PLLC enrolled in Medicare?
Yes. Legacy Primary Care PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Legacy Primary Care PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 22 clinicians in 2 Medicare specialties reassign their Medicare billing to Legacy Primary Care PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (20) and Family Practice (2). Of these, 3 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Legacy Primary Care PLLC accept?
Health plans from Blue Cross Blue Shield of North Dakota, Blue Cross Blue Shield of Wyoming and Sanford Health Plan list Legacy Primary Care PLLC 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 Primary Care PLLC was last updated on July 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Legacy Primary Care Pllc · NPI 1265277115
Adult Medicine organization in Grand Forks, North Dakota. Organization record, active in the CMS NPPES registry since July 1, 2024.
## Identity
- **NPI:** 1265277115 (Entity type: Organization)
- **Enumerated:** July 1, 2024
- **Primary specialty:** Family Medicine - Adult Medicine · taxonomy 207QA0505X
- **Organization subpart:** No
- **Authorized official:** Heidi Williams, CRED SPEC
## Practice location
- **Address:** 2100 S COLUMBIA RD STE 114, Grand Forks, ND 58201-5895
- **Phone:** (701) 516-4637 · **Fax:** (877) 651-1381
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 22 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (20), Family Practice (2); 3 practice at this address; [full list](https://npiprofile.com/npi/1265277115/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 1, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1265277115) · Data from the CMS NPPES public registry.