Legacy Physician Group, P.C.
NPI 1801800719ActiveOrganization· Specialist· Lansing, MI
Specialist in Lansing, Michigan, registered in NPPES in July 2006. The authorized official on file is Susan Therese Fedewa, DR, President. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1801800719 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 28, 2006 |
| Last updated in NPPES | Feb 18, 2025 |
| Certified by provider | Feb 5, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist Primary | 174400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MI) |
|---|
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