LEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC
NPI 1487272910
Nurse Practitioner - Psychiatric/Mental Health in Temple Hills, MD
About Legacy Medical Clinic With Mental Health, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
LEGACY MEDICAL CLINIC WITH MENTAL HEALTH, LLC (NPI 1487272910) is a healthcare organization registered as a psychiatric/mental health in Temple Hills, Maryland and active in the NPI registry since July 2020. The organization maintains a secondary practice location in Annapolis and lists Chinasa L Nwaulu, Co-owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Group Practice 1
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 Medical Clinic With Mental Health, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
3Medicare enrollment records show 3 clinicians reassign Medicare billing to Legacy Medical Clinic With Mental Health, LLC, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (3)
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 Medical Clinic With Mental Health, LLC's NPI number?
The NPI number for Legacy Medical Clinic With Mental Health, LLC is 1487272910. It was assigned to this organization in the NPPES registry on July 10, 2020.
Where is Legacy Medical Clinic With Mental Health, LLC located?
Legacy Medical Clinic With Mental Health, LLC is located at 4700 Stamp Rd Ste K, Temple Hills, MD 20748. The listed phone number is (301) 880-4900.
What is Legacy Medical Clinic With Mental Health, LLC's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Legacy Medical Clinic With Mental Health, LLC enrolled in Medicare?
Yes. Legacy Medical Clinic With Mental Health, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Legacy Medical Clinic With Mental Health, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Legacy Medical Clinic With Mental Health, LLC, in Clinical Social Worker and Nurse Practitioner. 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Legacy Medical Clinic With Mental Health, LLC was last updated on February 13, 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 Medical Clinic With Mental Health, Llc · NPI 1487272910
Psychiatric/Mental Health organization in Temple Hills, Maryland. Organization record, active in the CMS NPPES registry since July 10, 2020.
## Identity
- **NPI:** 1487272910 (Entity type: Organization)
- **Enumerated:** July 10, 2020
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **Organization subpart:** No
- **Authorized official:** Chinasa Nwaulu, CO-OWNER
## Practice location
- **Address:** 4700 STAMP RD STE K, Temple Hills, MD 20748-6717
- **Phone:** (301) 880-4900
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 3 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (2), Clinical Social Worker (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** February 13, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1487272910) · Data from the CMS NPPES public registry.