Organization Active NPI

Legacy Care LLC

  • Family Medicine Physician
  • Virginia Beach, VA
National Provider Identifier
1902149776
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LEGACY CARE LLC
Practice address
780 Lynnhaven Pkwy Ste 400
Virginia Beach, VA 23452-7332
Phone
(757) 536-2246
NPI assigned
Mar 30, 2013
Last updated
Mar 20, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Authorized official

Name
Desi-Rae Hall
Title
Delegated Official
Phone
(757) 251-9419

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X VA Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X VA

Addresses

Primary practice location

780 Lynnhaven Pkwy Ste 400
Virginia Beach, VA 23452-7332

Mailing address

PO Box 645986
Pittsburgh, PA 15264-5257

Other practice location 1

1840 Reisterstown Rd
Pikesville, MD 21208-1305
Phone (833) 815-2200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA, MD, DC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20130529000542 VA Part B Supplier - Clinic/Group Practice 0042458200 Receives reassigned benefits from 61 practitioners
Practice locations: Virginia Beach, VA
O20171116001376 MD Part B Supplier - Clinic/Group Practice 0042458200 Receives reassigned benefits from 1 practitioner
Practice locations: Pikesville, MD
O20180806002000 DC Part B Supplier - Clinic/Group Practice 0042458200 Receives reassigned benefits from 1 practitioner
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Locations (25 of 28)

7106 Ridge Rd
Ste 700
Rosedale, MD 21237

100 Water Grande Blvd
Little River, SC 29566
Phone (843) 366-4000

715 Argyll St
Chesapeake, VA 23320
Phone (757) 547-4528

2400 McKinney Blvd
Ste 100
Colonial Beach, VA 22443

1575 Scott Dr
Farmville, VA 23901
Phone (434) 392-8806

1575 Scott Dr
#5
Farmville, VA 23901

1575 Scott Dr
Ste 5
Farmville, VA 23901

5000 Spotsylvania Pkwy
Fredericksburg, VA 22407
Phone (540) 898-1205

6039 Mechanicsville Tpke
Mechanicsville, VA 23111

1120 Huguenot Rd
Midlothian, VA 23113

14001 Turnberry Ln
Midlothian, VA 23113
Phone (804) 897-2727

4931 Ridgedale Pkwy
North Chesterfield, VA 23234
Phone (804) 271-9502

9101 Bon Air Crossings Dr
North Chesterfield, VA 23235
Phone (804) 521-9980

250 Flank Rd
Petersburg, VA 23805
Phone (804) 861-2223

13500 N Gayton Rd
Richmond, VA 23233
Phone (804) 360-7777

2400 Gaskins Rd
Richmond, VA 23238
Phone (804) 716-8188

4795 Bethlehem Rd
Ste G
Richmond, VA 23230
Phone (804) 467-1628

7231 Forest Ave
Ste 200
Richmond, VA 23226
Phone (804) 379-3835

103 Rosehill Dr
South Boston, VA 24592
Phone (434) 272-4201

30 Kings Crest Dr
Stafford, VA 22554
Phone (540) 288-9353

123 S Lynnhaven Rd
Virginia Beach, VA 23452

1628 Old Donation Pkwy
Virginia Beach, VA 23454
Phone (757) 496-3092

2133 Upton Dr
Ste 126
Virginia Beach, VA 23454

2900 Sabre St
Virginia Beach, VA 23452

2900 Sabre St
Ste 300
Virginia Beach, VA 23452
Phone (757) 222-0300

Practitioners & affiliated clinicians

Practitioners 85

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 85

NPI Registry JSON

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

{
    "created_epoch": "1364601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1773964800000",
    "number": "1902149776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 645986",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152645257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 LYNNHAVEN PKWY STE 400",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234527332",
            "telephone_number": "757-536-2246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1840 Reisterstown Rd",
            "address_purpose": "LOCATION",
            "city": "Pikesville",
            "state": "MD",
            "postal_code": "212081305",
            "country_code": "US",
            "telephone_number": "833-815-2200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEGACY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-30",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DESI-RAE",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "757-251-9419"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "VA",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.