LEGACY SPINE AND PAIN, LLC (NPI# 1447755178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447755178 |
| Entity Type | Organization |
| Organization Name | LEGACY SPINE AND PAIN, LLC |
| Practice Address |
10421 Motor City Dr # 342430 Bethesda MD 20817-9996 |
| Practice Telephone | 3019624278 |
| Mailing Telephone | 3019624278 |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2019-09-19 |
| Authorized Official Name | EHSAN ABDESHAHIAN (OWNER) |
| Authorized Official Telephone | 4108004466 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
Ambulatory Health Care Facilities |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4201 Northview Drive, Suite 104, Bowie, MD 20716 | 4108004466 |
| Street Address |
10421 MOTOR CITY DR # 342430 |
| City | BETHESDA |
| State | MD |
| Zip Code | 20817-9996 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972135291 | Super Smile Center of Bethesda | Dentist | 10320 Westlake Dr., Suite# 109, Bethesda, MD 20817 | 2020-02-05 |
| 1659918175 | Morgan Cheatham | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd, Suite 300, Bethesda, MD 20817 | 2019-12-03 |
| 1780233601 | Natalie Milazzo | Behavior Technician | Attattn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-09-04 |
| 1366090649 | Sarah Danko | Behavior Technician | Attn: Behavioral Health Works 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-29 |
| 1679120760 | Markita Mccurdy | Behavior Technician | 6701 Democracy Blvd., Suite 300, Bethesda, MD 20817 | 2019-08-22 |
| 1548716277 | Roberta Glass | Psychiatry & Neurology | 9806 Marquette Dr., Bethesda, MD 20817 | 2016-09-01 |
| 1952725525 | Jenna Kuhn | Student in an Organized Health Care Education/Training Program | 6701 Democracy Blvd. Attn: Behavioral Health Works, Suite 300, Bethesda, MD 20817 | 2014-02-18 |
| 1912338088 | Nayereh Nina Ghamarian | Dentist | 6017 Bradley Blvd, Bethesda, MD 20817 | 2013-11-27 |
| 1386076495 | Hugo Galindo | Physical Therapist | 6410 Rockledge Drive, Suite 100, Nrh Rehabilitation Network Bethesda, Bethesda, MD 20817 | 2013-07-31 |
| 1538509260 | Anameti Usoro | Anesthesiology | 6430 Rockledge Dr Ste 160, Bethesda, MD 20817 | 2013-06-26 |
| Find all providers in zip 20817 | ||||
| Taxonomy Code | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669014098 | Maryland Pain and Spine Center, LLC | Clinic/Center | 844 Washington Rd Ste 207, Westminster, MD 21157-6664 | 2019-10-17 |
| 1285196295 | Xpress Medical Specialties, LLC | Clinic/Center | 12200 Annapolis Rd Ste 225, Glenn Dale, MD 20769-9182 | 2019-04-01 |
| 1710453808 | Young Ji Acupuncture Clinic | Clinic/Center | 3459 Saint Johns Ln Ste 9, Ellicott City, MD 21042-4026 | 2018-10-16 |
| 1164775979 | Potomac Healthcare Alliance | Clinic/Center | 198 Thomas Johnson Dr Ste 5, Frederick, MD 21702-4449 | 2012-10-17 |
| 1194018085 | Healthy Life Medical Group, Inc | Clinic/Center | 9607 Reisterstown Rd, Owings Mills, MD 21117-4129 | 2011-05-25 |
| 1881917383 | Workwell Physicals Inc | Clinic/Center | 7711 Garrison Rd, Hyattsville, MD 20784-1756 | 2010-03-11 |
| 1548582877 | Alt. Medicine Inc. | Clinic/Center | 3201 Corporate Ct Fl 1, Ellicott City, MD 21042-2247 | 2010-03-01 |
| 1174853626 | Carlos S. Santiago IIi, Mdpc | Clinic/Center | 924 Seton Dr Ste 1, Cumberland, MD 21502-1851 | 2010-01-06 |
| 1295983997 | Qol Pain Management LLC. | Clinic/Center | 3102 N Hilton St, Baltimore, MD 21216-1450 | 2008-09-05 |
| 1174711949 | Surgery Centers of Delmarva, LLC | Clinic/Center | 101 Chesapeake Blvd, Suite C, Elkton, MD 21921-6313 | 2007-10-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.