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LEGACY HEALTH PA
NPI 1780147108
Clinic/Center - Health Service in Matthews, NC

Active since April 11, 2019CLIA 34D2312003 · Waiver
3049 SENNA DR, MATTHEWS, NC 28105(980) 339-5155(980) 216-8522 Get Directions Write a Review

NPPES record last updated: April 11, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Legacy Health Pa NPPES

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

LEGACY HEALTH PA (NPI 1780147108), doing business as Legacy Health, is a healthcare organization registered as a health service in Matthews, North Carolina and active in the NPI registry since April 2019. The organization holds a CLIA Waiver certificate valid through October 1, 2026 and lists Brian Jerby, Lead Physician, as its authorized official.

NPPES Registry Identity

NPI1780147108
Entity TypeOrganization
Primary Taxonomy261QH0100X
Legal Business NameLEGACY HEALTH PA
Location Address3049 SENNA DRMatthews, NC 28105-6727
Mailing Address3049 Senna DrMatthews, NC 28105-6727 · (980) 339-5155
Phone(980) 339-5155
Fax(980) 216-8522
Organization SubpartNo
Authorized OfficialBrian JerbyLead Physician · (980) 339-5155
Enumeration DateApril 11, 2019
✔ NPI 1780147108 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Health ServiceAmbulatory Health Care Facilities
Taxonomy Code261QH0100X
3049 SENNA DR, Matthews, NC 28105
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Other Names 1

Doing Business AsLegacy Health

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 34D2312003

Legacy Health PA · Matthews, NC
Active · expires Oct 1, 2026
CLIA Number34D2312003
Laboratory TypePhysician Office
Certificate Effective DateOctober 2, 2024
Certificate Expiration DateOctober 1, 2026
Laboratory DirectorSusan H. Jerby
Laboratory Phone(980) 339-5155
Laboratory LocationLegacy Health PA3049 Senna Drive, Matthews, NC 28105
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.

VICTORIA SOMERVAIL HOLMES MOORE
Physician Assistant
3049 SENNA DR
MATTHEWS, NC 28105
Mecklenburg County (336) 467-3337
MRS. SUSAN HEATHER JERBY AGNP-C
Nurse Practitioner
3049 SENNA DR
MATTHEWS, NC 28105
Mecklenburg County (980) 339-5155
CAROLINA COLON & RECTAL SPECIALISTS PA
Colon & Rectal Surgery
3049 SENNA DR
MATTHEWS, NC 28105
Mecklenburg County (980) 339-5155

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 Health PA's NPI number?

The NPI number for Legacy Health PA is 1780147108. It was assigned to this organization in the NPPES registry on April 11, 2019. The provider is doing business as Legacy Health.

Where is Legacy Health PA located?

Legacy Health PA is located at 3049 Senna Dr, Matthews, NC 28105. The listed phone number is (980) 339-5155.

What is Legacy Health PA's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Health Service, with taxonomy code 261QH0100X.

Does Legacy Health PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 34D2312003) is associated with this NPI, valid through October 1, 2026. 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 Health PA was last updated on April 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.