LEGACY DEVELOPMENTAL PEDIATRICS, PLLC
NPI 1295596096
Nurse Practitioner in Lubbock, TX

Q: What is Legacy Developmental Pediatrics, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Active since January 18, 2024

2505 79TH ST STE B, LUBBOCK, TX 79423(806) 300-8228(806) 300-8223 Get Directions Write a Review

NPPES record last updated: April 16, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Legacy Developmental Pediatrics, Pllc NPPES

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

LEGACY DEVELOPMENTAL PEDIATRICS, PLLC (NPI 1295596096), doing business as Legacy Developmental Pediatrics, is a healthcare organization registered as a nurse practitioner in Lubbock, Texas and active in the NPI registry since January 2024. The organization lists Patricia Perez, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1295596096

Entity TypeOrganization

Primary Taxonomy363L00000X

Legal Business NameLEGACY DEVELOPMENTAL PEDIATRICS, PLLC

Location Address2505 79TH ST STE BLubbock, TX 79423-2211

Mailing Address2505 79th St Ste BLubbock, TX 79423-2211 · (806) 300-8228 · Fax (806) 300-8223

Phone(806) 300-8228

Fax(806) 300-8223

Organization SubpartNo

Authorized OfficialPatricia PerezNurse Practitioner · (806) 300-8228

Enumeration DateJanuary 18, 2024

Last NPPES UpdateApril 16, 2025

NPPES CertifiedApril 16, 2025

✔ NPI 1295596096 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

2505 79TH ST STE B, Lubbock, TX 79423

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Other Names 1

Doing Business AsLegacy Developmental Pediatrics

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 Blue Cross and Blue Shield of Texas, WellPoint.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 Developmental Pediatrics, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 3 clinicians reassign Medicare billing to Legacy Developmental Pediatrics, PLLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Dawn Conwright, CPNP

Nurse Practitioner

NPI 1558720045

2505 79TH ST STE B
Lubbock, TX 79423

(806) 300-8228

✔ PECOS✔ Accepts MedicareSame address

Lisa Davenport, APRN-CNP,PMHNP-BC

Nurse Practitioner

NPI 1861918344

2403 82ND ST
Lubbock, TX 79423

(806) 300-8228

✔ PECOS✔ Accepts Medicare0.3 mi

Roberta Weaver, FNP

Nurse Practitioner

NPI 1356646087

1318 BROADWAY
Lubbock, TX 79401

(806) 765-2611

✔ PECOS✔ Accepts Medicare4.5 mi

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 Developmental Pediatrics, PLLC's NPI number?

The NPI number for Legacy Developmental Pediatrics, PLLC is 1295596096. It was assigned to this organization in the NPPES registry on January 18, 2024. The provider is doing business as Legacy Developmental Pediatrics.

Where is Legacy Developmental Pediatrics, PLLC located?

Legacy Developmental Pediatrics, PLLC is located at 2505 79th St Ste B, Lubbock, TX 79423. The listed phone number is (806) 300-8228.

What is Legacy Developmental Pediatrics, PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Legacy Developmental Pediatrics, PLLC enrolled in Medicare?

Yes. Legacy Developmental Pediatrics, PLLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Legacy Developmental Pediatrics, PLLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Legacy Developmental Pediatrics, 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. Of these, 1 practice at this address and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Legacy Developmental Pediatrics, PLLC accept?

Health plans from Blue Cross and Blue Shield of Texas and WellPoint list Legacy Developmental Pediatrics, 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 Developmental Pediatrics, PLLC was last updated on April 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.