LEGACY HEALTHCARE ADVANTAGE LLC
NPI 1568974863
In Home Supportive Care in Spartanburg, SC
NPI Status: Active since October 26, 2017
Contact Information
371 E HENRY ST
SPARTANBURG, SC
ZIP 29302
Phone: (864) 431-4273
- Organization
- In Home Supportive Care
- CLIA Number: 42D2237546
- CLIA Cert. Type: Independent
- CLIA Exp. Date: 09-26-2027
About LEGACY HEALTHCARE ADVANTAGE LLC
This page provides the complete NPI Profile along with additional information for Legacy Healthcare Advantage Llc, a provider established in Spartanburg, South Carolina operating as a In Home Supportive Care. The healthcare provider is registered in the NPI registry with number 1568974863 assigned on October 2017. The practitioner's primary taxonomy code is 253Z00000X. 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 Cortella Wilkes (Owner)
- NPI
- 1568974863
- Provider Name
- LEGACY HEALTHCARE ADVANTAGE LLC
- Entity Type
- Organization
- Location Address
- 371 E HENRY ST SPARTANBURG, SC 29302
- Location Phone
- (864) 431-4273
- Mailing Address
- 531 MEADOWSEED CT LYMAN, SC 29365
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 10-26-2017
- Last Update Date
- 08-16-2022
- Code Navigator
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
In Home Supportive Care
- Taxonomy Code
- 253Z00000X
- Type
- Agencies
- Taxonomy Description
- 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.
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) |
|---|---|---|---|---|
| 1 | 251B00000X | Agencies | Case Management | |
| 2 | 251E00000X | Agencies | Home Health | |
| 3 | 251G00000X | Agencies | Hospice Care, Community Based | |
| 4 | 251J00000X | Agencies | Nursing Care | |
| 5 | 251S00000X | Agencies | Community/Behavioral Health | |
| 6 | 291U00000X | Laboratories | Clinical Medical Laboratory | |
| 7 | 302R00000X | Managed Care Organizations | Health Maintenance Organization | |
| 8 | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| 9 | 385H00000X | Respite Care Facility | Respite Care | |
| 10 | 385HR2055X | Respite Care Facility | Respite Care | |
| 11 | 385HR2060X | Respite Care Facility | Respite Care | |
| 12 | 385HR2065X | Respite Care Facility | Respite Care |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| EN1733 | MEDICAID (05) | SC |
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 42D2237546
- Facility Type
- Independent
- Certificate Effective Date
- September 27, 2025
- Certificate Expiration Date
- September 26, 2027
- Laboratory Director
- CORTELLA WILKES
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Legacy Healthcare Advantage Llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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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 1568974863, 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 77. The final step is to find the difference between that total and the next multiple of ten (80 - 77 = 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.
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.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 77 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1568974863, enumerated as an "organization" on October 26, 2017.
The provider is located at 371 E HENRY ST SPARTANBURG, SC 29302 and the phone number is (864) 431-4273.
In Home Supportive Care with taxonomy code 253Z00000X.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
