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LEGACY MEDICAL GROUP, PLLC
NPI 1558010843
Internal Medicine in Greensboro, NC

Active since March 22, 2022
302 POMONA DR STE L, GREENSBORO, NC 27407(336) 763-1980 Get Directions Write a Review

NPPES record last updated: March 22, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Legacy Medical Group, Pllc NPPES

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

LEGACY MEDICAL GROUP, PLLC (NPI 1558010843) is a healthcare organization registered as an internal medicine in Greensboro, North Carolina and active in the NPI registry since March 2022. The organization lists Tiara Shackleford, Nurse Practitioner, as its authorized official.

NPPES Registry Identity

NPI1558010843
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameLEGACY MEDICAL GROUP, PLLC
Location Address302 POMONA DR STE LGreensboro, NC 27407-1642
Mailing Address302 Pomona Dr Ste LGreensboro, NC 27407-1642
Phone(336) 763-1980
Organization SubpartNo
Authorized OfficialTiara ShacklefordNurse Practitioner · (336) 944-9950
Enumeration DateMarch 22, 2022
NPPES CertifiedMarch 22, 2022
✔ NPI 1558010843 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHome InfusionTaxonomy 251F00000X
Also ListedClinic/Center · Infusion TherapyTaxonomy 261QI0500X
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
302 POMONA DR STE L, Greensboro, NC 27407
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Other Providers at the Same Location NPPES 3

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

MRS. SAMANTHA REIFF M.S., R.D
Dietitian, Registered
302 POMONA DR STE L
GREENSBORO, NC 27407
Guilford County (336) 541-6475
MRS. DENISE L ROBINSON RD
Dietitian, Registered
302 POMONA DR STE L
GREENSBORO, NC 27407
Guilford County (336) 541-6475
AMNAZO CHRISTEL MUHIRWA FNP
Nurse Practitioner (Family)
302 POMONA DR STE L
GREENSBORO, NC 27407
Guilford County (866) 822-4606

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 Group, PLLC's NPI number?

The NPI number for Legacy Medical Group, PLLC is 1558010843. It was assigned to this organization in the NPPES registry on March 22, 2022.

Where is Legacy Medical Group, PLLC located?

Legacy Medical Group, PLLC is located at 302 Pomona Dr Ste L, Greensboro, NC 27407. The listed phone number is (336) 763-1980.

What is Legacy Medical Group, PLLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

When was this NPI record last updated?

The NPPES record for Legacy Medical Group, PLLC was last updated on March 22, 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.