Individual provider Active NPI

Jeremy Legates, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Dover, DE
National Provider Identifier
1073089801
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
L8-0010461 Issued in DE
Practice address
1305 MCD Dr
Dover, DE 19901-4699
Phone
(302) 883-2926
Fax
(302) 883-3799
NPI assigned
Oct 19, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X L1-0054237 DE
Psychiatric/Mental Health Nurse Practitioner 363LP0808X L8-0010461 DE Primary

Addresses

Primary practice location

1305 MCD Dr
Dover, DE 19901-4699

Mailing address

302 Woodsedge LN
Felton, DE 19943-9542
Phone (443) 710-2139

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240305000110 DE Practitioner - Nurse Practitioner 6709221492 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Mind and Body Consortium, LLC.Group PAC ID 9739234014, 19 clinicians

Practice addresses (Care Compare)

156 S State St
Dover, DE 19901-7314
Phone 302674238039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
L1-0054237DEMDRegistered Nurse
L8-0010461DEMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA CurrentSince Nov 1, 2025 Accepting new patients
The Mind and Body Consortium, LLC. CurrentSince Oct 20, 2024 Accepting new patients

Locations

156 S State St
Dover, DE 19901
Phone 30267423801218

118 Sandhill Dr
Ste 201
Middletown, DE 19709
Phone 3024499314108

1000 N West St
Ste 1200
Wilmington, DE 19801
Phone (302) 449-6471

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1073089801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 WOODSEDGE LN",
            "city": "FELTON",
            "state": "DE",
            "postal_code": "199439542",
            "telephone_number": "443-710-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 MCD DR",
            "city": "DOVER",
            "state": "DE",
            "postal_code": "199014699",
            "telephone_number": "302-883-2926",
            "fax_number": "302-883-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGATES",
        "first_name": "JEREMY",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-19",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "DE",
            "license": "L1-0054237",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "DE",
            "license": "L8-0010461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, DE

Sources for this page

Verify at the official NPI Registry.