Russell Brooks Legg VII, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WV-2123 Issued in WV

Practice address

63 Carr St
Clay, WV 25043-9402

Phone

(304) 587-4232

Fax

(304) 587-2092

NPI assigned

Jun 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• R. Brooks Legg Jr.

  • General Practice Dentistry
  • Clay, WV
  • NPI 1912088410
  NPD (past) Authorized official
• John G. Hubbard, DDS, PLLC

  • General Practice Dentistry
  • Clay, WV
  • NPI 1336498104
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323734400000",
    "number": "1285673905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 CARR ST",
            "address_2": "P. O. BOX 568",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "250439402",
            "telephone_number": "304-587-4232",
            "fax_number": "304-587-2092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 CARR ST",
            "city": "CLAY",
            "state": "WV",
            "postal_code": "250439402",
            "telephone_number": "304-587-4232",
            "fax_number": "304-587-2092"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGG",
        "first_name": "RUSSELL",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "name_suffix": "VII",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2011-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WV",
            "license": "WV-2123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0135486000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "WV2123",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MT. STATE BC/BS INSURANCE",
            "identifier": "000728088",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA INSURANC",
            "identifier": "728088",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEIN NUMBER",
            "identifier": "55-0560454",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caleb Michael Leake
• Andrea Leftwich
• Angela Leftwich
• Sabrina Faye Leftwich
• Melissa Jean Legg
• Shilo Lippert
• Tammy Lee Looney
• Michelle Lough
• Shawana Lyons
• Karrie Michelle Mace, M.A., ED.S

• General Practice Dentistry in Clay, WV
• Providers in Clay, WV by specialty
• General Practice Dentistry in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.