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LEGACY HEALTHCARE ADVANTAGE LLC
NPI 1568974863
In Home Supportive Care in Spartanburg, SC

Active since October 26, 2017CLIA 42D2237546 · Waiver
371 E HENRY ST, SPARTANBURG, SC 29302(864) 431-4273 Get Directions Write a Review

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

Record update history: Aug 16, 2022, Feb 4, 2022, Mar 10, 2019 and 1 more (4 updates tracked since 2017).

About Legacy Healthcare Advantage Llc NPPES

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

LEGACY HEALTHCARE ADVANTAGE LLC (NPI 1568974863) is a healthcare organization registered as an in home supportive care in Spartanburg, South Carolina and active in the NPI registry since October 2017. The organization holds a CLIA Waiver certificate valid through September 26, 2027 and lists Cortella Wilkes, Owner, as its authorized official.

NPPES Registry Identity

NPI1568974863
Entity TypeOrganization
Primary Taxonomy253Z00000X
Legal Business NameLEGACY HEALTHCARE ADVANTAGE LLC
Location Address371 E HENRY STSpartanburg, SC 29302-2607
Mailing Address531 Meadowseed CtLyman, SC 29365-1357
Phone(864) 431-4273
Organization SubpartNo
Authorized OfficialCortella WilkesOwner · (864) 308-8712
Enumeration DateOctober 26, 2017
Last NPPES UpdateAugust 16, 20224 updates tracked since enumeration
NPPES CertifiedAugust 16, 2022
✔ NPI 1568974863 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 13

★ Primary SpecialtyIn Home Supportive CareAgencies
Taxonomy Code253Z00000X
Definition
An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.
Also ListedCase ManagementTaxonomy 251B00000X
Also ListedHome HealthTaxonomy 251E00000X
Also ListedHospice Care, Community BasedTaxonomy 251G00000X
Also ListedNursing CareTaxonomy 251J00000X
Also ListedCommunity/Behavioral HealthTaxonomy 251S00000X
Also ListedClinical Medical LaboratoryTaxonomy 291U00000X
Also ListedHealth Maintenance OrganizationTaxonomy 302R00000X
Also ListedCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesTaxonomy 320900000X
Also ListedRespite CareTaxonomy 385H00000X
Also ListedRespite Care · Respite Care, Mental Illness, ChildTaxonomy 385HR2055X
Also ListedRespite Care · Respite Care, Intellectual and/or Developmental DisabilitiesTaxonomy 385HR2060X
Also ListedRespite Care · Respite Care, Physical Disabilities, ChildTaxonomy 385HR2065X
371 E HENRY ST, Spartanburg, SC 29302
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Other Identifiers 1

MedicaidEN1733SC

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 42D2237546

Legacy Healthcare Advantage, LLC · Spartanburg, SC
Active · expires Sep 26, 2027
CLIA Number42D2237546
Laboratory TypeIndependent
Certificate Effective DateSeptember 27, 2025
Certificate Expiration DateSeptember 26, 2027
Laboratory DirectorCortella Wilkes
Laboratory Phone(864) 308-8712
Laboratory LocationLegacy Healthcare Advantage, LLC371 E Henry St, Spartanburg, SC 29302
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

LEGACY TRANSPORT SERVICES
Non-emergency Medical Transport (VAN)
371 E HENRY ST
SPARTANBURG, SC 29302
Spartanburg County (864) 360-2971
CORTELLA WILKES DNP
Registered Nurse
371 E HENRY ST
SPARTANBURG, SC 29302
Spartanburg County (864) 308-8712
LEGACY TRANSPORT SERVICES
Ambulance (Land Transport)
371 E HENRY ST
SPARTANBURG, SC 29302
Spartanburg County (864) 360-2971

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 Healthcare Advantage LLC's NPI number?

The NPI number for Legacy Healthcare Advantage LLC is 1568974863. It was assigned to this organization in the NPPES registry on October 26, 2017.

Where is Legacy Healthcare Advantage LLC located?

Legacy Healthcare Advantage LLC is located at 371 E Henry St, Spartanburg, SC 29302. The listed phone number is (864) 431-4273.

What is Legacy Healthcare Advantage LLC's specialty?

The primary specialty registered for this NPI is In Home Supportive Care with taxonomy code 253Z00000X.

Does Legacy Healthcare Advantage LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 42D2237546) is associated with this NPI, valid through September 26, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Legacy Healthcare Advantage LLC was last updated on August 16, 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.