Legacy Spine and Pain, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

LEGACY SPINE AND PAIN, LLC

Practice address

10421 Motor City Dr # 342430
Bethesda, MD 20817-9996

Phone

(301) 962-4278

Fax

(833) 781-1112

NPI assigned

Mar 26, 2018

Organization subpart

No

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

Authorized official

Name

Ehsan Abdeshahian, MD

Title

Owner

Phone

(410) 800-4466

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1522022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607904000000",
    "number": "1447755178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10421 MOTOR CITY DR # 342430",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208179996",
            "telephone_number": "301-962-4278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10421 MOTOR CITY DR # 342430",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208179996",
            "telephone_number": "301-962-4278",
            "fax_number": "833-781-1112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4201 Northview Drive",
            "address_2": "Suite 104",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "20716",
            "country_code": "US",
            "telephone_number": "410-800-4466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY SPINE AND PAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-26",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A",
        "authorized_official_last_name": "ABDESHAHIAN",
        "authorized_official_first_name": "EHSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-800-4466",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ui Sung Lee, DO
• Vivian Lee, MD
• Weiraymond M Lee, PHARM D
• David Eric Lees, M.D
• Elyse Leevan, M.D.
• Cody Legler, DNP, NP-BC
• Sonya Christine Legrand
• Tanya J. Lehky, M.D.
• Douglas Lehman, LCSW, CAC III
• Richard T Lei, DDS

• Pain Clinic/Center in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Pain Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.