Legacy Primary Care and Wellness

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LEGACY PRIMARY CARE AND WELLNESS

Practice address

195 Upper Riverdale Rd SW Ste B
Riverdale, GA 30274-2518

Phone

(770) 703-8465

Fax

(770) 629-2392

NPI assigned

Dec 2, 2020

Last updated

Aug 12, 2021By 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

Betty Elizabeth Strong, MD

Title

Physician/Owner

Phone

(770) 703-8465

Specialties & licenses 1

Addresses

Other names 1

• Legacy Primary Care and Wellness LLC Other name

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

{
    "created_epoch": "1606867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1628726400000",
    "number": "1508461070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 UPPER RIVERDALE RD SW STE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742518",
            "telephone_number": "770-703-8465",
            "fax_number": "770-629-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 UPPER RIVERDALE RD SW STE B",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742518",
            "telephone_number": "770-703-8465",
            "fax_number": "770-629-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY PRIMARY CARE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-02",
        "last_updated": "2021-08-12",
        "certification_date": "2021-08-09",
        "status": "A",
        "authorized_official_last_name": "STRONG",
        "authorized_official_first_name": "BETTY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "770-703-8465",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Legacy Primary Care and Wellness LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Terri Lynn Ledoux, AGACNP-BC
• Charnise Lashae Lee
• Moo Hee Lee, MD
• Legacy Brain & Spine LLC (Legacy Brain & Spine LLC - Riverdale)
• Legacy Center for Spinal Surgery- Riverdale LLC
• Khemaporn Lertdetkajorn, MD
• Rodney Fitzgerald Lester Jr.
• Jennifer Leverett, PHARM.D.
• Brittany Lewis
• Jacob Dwayne Lewis

• Primary Care Clinic/Center in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2021; 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.