Legacy Dialysis of Virginia

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

LEGACY DIALYSIS OF VIRGINIA

Practice address

211 Gibson St NW Ste 209
Leesburg, VA 20176-2115

Phone

(954) 781-7741

Fax

(888) 349-8679

NPI assigned

Apr 3, 2020

Last updated

Feb 26, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Marcia Anjos Santos

Title

Coo

Phone

(954) 781-7741

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Listed as

Legacy Dialysis of Virgina, LLCCCN 492740

Overall star rating

4.0 of 5

Ownership

Profit

Certified

May 28, 2021

Medicare certification status

ActiveFrom the Provider of Services file

Dialysis stations

3

Locations

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Renuka Sothinathan, M.D.

  • Nephrology Physician
  • Fairfax, VA
  • NPI 1225124779

  Dialysis facility

  Care Compare affiliation Name & address match

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

{
    "created_epoch": "1585872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740528000000",
    "number": "1447889399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 E SAMPLE RD STE 301",
            "city": "POMPANO BEACH",
            "state": "FL",
            "postal_code": "330643552",
            "telephone_number": "954-781-7741",
            "fax_number": "888-349-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 GIBSON ST NW STE 209",
            "city": "LEESBURG",
            "state": "VA",
            "postal_code": "201762115",
            "telephone_number": "954-781-7741",
            "fax_number": "888-349-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY DIALYSIS OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-03",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A",
        "authorized_official_last_name": "SANTOS",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "ANJOS",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "954-781-7741"
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leesburg Life Care, LLC (Heritage Hall - Leesburg)
• Leesburg Modern Dentistry, PC (Leesburg Modern Dentistry)
• Leesburg Optometry, LLC (My Eye Dr.)
• Leesburg Premier Dental
• Leesburg Sports, Inc. (Select Physical Therapy)
• Legacy Orthodontics, PLC
• Gabrielle La Porta Leger, PA-C
• Shannon Catherine Lehr, M.D.
• Kendall Leigh, OD
• Tessa G Leith, AGACNP-BC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Leesburg, VA
• Providers in Leesburg, VA by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.