Individual provider Active NPI

Nicholas Leggo

  • Psychiatric/Mental Health Nurse Practitioner
  • Boynton Beach, FL
National Provider Identifier
1295482693
Registry record updated Feb 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
11033691 Issued in FL
Practice address
3469 W Boynton Beach Blvd Ste 18
Boynton Beach, FL 33436-4639
Phone
(561) 576-9404
NPI assigned
Mar 4, 2022
Last updated
Feb 5, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 11033691 FL Primary

Addresses

Primary practice location

3469 W Boynton Beach Blvd Ste 18
Boynton Beach, FL 33436-4639

Mailing address

2046 Alta Meadows LN Apt 1903
Delray Beach, FL 33444-1176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
11033691FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mindspa, LLC CurrentSince Feb 9, 2025 Accepting new patients

Locations

3469 W Boynton Beach Blvd
Ste 18
Boynton Beach, FL 33436
Phone (561) 576-9404

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1646352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738713600000",
    "number": "1295482693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 ALTA MEADOWS LN APT 1903",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334441176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3469 W BOYNTON BEACH BLVD STE 18",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334364639",
            "telephone_number": "561-576-9404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGO",
        "first_name": "NICHOLAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-04",
        "last_updated": "2025-02-05",
        "certification_date": "2025-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "11033691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boynton Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2025; 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.