Legacy Village for Rehabilitation & Memory Care – Skilled Nursing Facility, NPI 1881866499

Legacy Village for Rehabilitation & Memory Care is a healthcare provider. based in Taylorsville, Utah. specializing in Skilled Nursing Facility. The organization holds a License No. TO BE DETERMINED (UT). The NPI Number for Legacy Village for Rehabilitation & Memory Care is 1881866499

Main info

Organization
Name
Legacy Village for Rehabilitation & Memory Care
NPI
1881866499
Phone
(801) 269-0700
Address
1018 ATHERTON DR
Authorized Official
MR. PAUL C FAIRHOLM MANAGING MEMBER
Enumeration Date
24 March 2008
Last Update Date
22 April 2015
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness80
Years active:18State licenses:2Digital endpointsUpdated within 12 months

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Provider Addresses for Legacy Village for Rehabilitation & Memory Care

  • 1018, Atherton Drive, Taylorsville, Salt Lake County, Utah, 84123, United States

    TAYLORSVILLE, UT 841233470

    Phone: (801) 269-0700

    Fax: (801) 269-1512

    Type: Mailing

  • 5472, 3200 West, Country Squire Estates, Taylorsville, Salt Lake County, Utah, 84129, United States

    TAYLORSVILLE, UT 841297804

    Phone: (801) 269-0700

    Fax: (801) 269-1512

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2009-05-28

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20090528000310OSkilled Nursing FacilityUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84123)

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Reviews

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Frequently asked questions

Does Legacy Village for Rehabilitation & Memory Care have a public NPI I can cite?
Public records show Legacy Village for Rehabilitation & Memory Care under NPI 1881866499.
Does the public listing show Legacy Village for Rehabilitation & Memory Care as active?
Legacy Village for Rehabilitation & Memory Care's NPI record reflects an active status in NPPES.
What type of care does Legacy Village for Rehabilitation & Memory Care provide?
Legacy Village for Rehabilitation & Memory Care's profile centers on Skilled Nursing Facility. Clinical services aligned with this taxonomy classification.
Is Legacy Village for Rehabilitation & Memory Care tied to Taylorsville, Utah?
If you are local to Taylorsville, Utah, Legacy Village for Rehabilitation & Memory Care may be relevant to your search.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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