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

NPI Status: Active since March 22, 2022

Contact Information

302 POMONA DR STE L
GREENSBORO, NC
ZIP 27407
Phone: (336) 763-1980

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  • Organization
  • Internal Medicine

About LEGACY MEDICAL GROUP, PLLC

This page provides the complete NPI Profile along with additional information for Legacy Medical Group, Pllc, an internist established in Greensboro, North Carolina operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1558010843 assigned on March 2022. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 4 years ago. The authorized official of this NPI record is Tiara Shackleford Fnp (Nurse Practitioner)

NPI
1558010843
Provider Name
LEGACY MEDICAL GROUP, PLLC
Entity Type
Organization
Location Address
302 POMONA DR STE L GREENSBORO, NC 27407
Location Phone
(336) 763-1980
Mailing Address
302 POMONA DR STE L GREENSBORO, NC 27407
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-22-2022
Last Update Date
03-22-2022
Code Navigator

An internist like Legacy Medical Group, Pllc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
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.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1251F00000XAgencies

Home Infusion

 
2261QI0500XAmbulatory Health Care Facilities

Clinic/Center
Infusion Therapy

 
3261QP2300XAmbulatory Health Care Facilities

Clinic/Center
Primary Care

 

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

TIARA SHACKLEFORD FNP

Authorized Official Title
NURSE PRACTITIONER
Authorized Official Phone
(336) 944-9950

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1558010843, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 57. The final step is to find the difference between that total and the next multiple of ten (60 - 57 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
8
Unchanged
Pos 5
0
Doubled → 0
Pos 6
1
Unchanged
Pos 7
0
Doubled → 0
Pos 8
8
Unchanged
Pos 9
4
Doubled → 8
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 0 → 0 0 → 0 4 → 8

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 1 + 0 + 8 + 0 + 1 + 0 + 8 + 8 + 24 = 57

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 57 is 60. The difference is the calculated check digit.

60 - 57 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1558010843.

Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Dietitian, Registered
302 POMONA DR STE L
GREENSBORO, NC 27407
Nurse Practitioner (Family)
302 POMONA DR STE L
GREENSBORO, NC 27407
Dietitian, Registered
302 POMONA DR STE L
GREENSBORO, NC 27407

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1558010843, enumerated as an "organization" on March 22, 2022.

The provider is located at 302 POMONA DR STE L GREENSBORO, NC 27407 and the phone number is (336) 763-1980.

Internal Medicine with taxonomy code 207R00000X.