NPIMap

Organization Active NPI

Legacy Brain & Spine LLC

  • Neurological Surgery Physician
  • Tucker, GA
National Provider Identifier
1245070879
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
Legal business name
LEGACY BRAIN & SPINE LLC
Practice address
1918 Northlake Pkwy Ste 101
Tucker, GA 30084-7070
Phone
(770) 291-8987
NPI assigned
May 30, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Said Elshihabi, MDNPI 1467477463
Title
Owner
Phone
(770) 291-8987

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X Primary

Addresses

Primary practice location

1918 Northlake Pkwy Ste 101
Tucker, GA 30084-7070

Mailing address

1900 The Exchange SE Ste 200
Atlanta, GA 30339-2022
Phone (770) 291-8987

Other names 1

  • Legacy Brain & Spine LLC - Tucker Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Legacy Brain Spine LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717027200000",
    "number": "1245070879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 THE EXCHANGE SE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303392022",
            "telephone_number": "770-291-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1918 NORTHLAKE PKWY STE 101",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300847070",
            "telephone_number": "770-291-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY BRAIN & SPINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A",
        "authorized_official_last_name": "ELSHIHABI",
        "authorized_official_first_name": "SAID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-291-8987",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Brain & Spine LLC - Tucker",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.