Individual provider Active NPI

Heather Leonardy, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Juneau, AK
National Provider Identifier
1366987299
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
162668 Issued in AK
Practice address
3406 Glacier Hwy
Juneau, AK 99801-7251
Phone
(907) 463-3303
NPI assigned
Jan 2, 2017
Last updated
Jul 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X ARNP9344822 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN9344822 FL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 162668 AK Primary

Addresses

Primary practice location

3406 Glacier Hwy
Juneau, AK 99801-7251

Mailing address

52 Grove Ave
Saint Augustine, FL 32084-3256
Phone (904) 615-7669

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, VT2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190409001395 FL Practitioner - Nurse Practitioner 9830430446 Reassigns benefits to 1 organization
I20230317001054 VT Practitioner - Nurse Practitioner 9830430446 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brattleboro RetreatGroup PAC ID 7012828908, 61 clinicians

Practice addresses (Care Compare)

22 Anna Marsh LN
Dummerston, VT 05301-3292
Phone (802) 258-4391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9344822FLMDGeneral Practice Registered Nurse
162668AKMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sma Healthcare Inc CurrentSince Jan 4, 2022 Accepting new patients
Brattleboro Retreat CurrentSince Apr 1, 2023 Accepting new patients

Locations

301 Justice Ln
Bunnell, FL 32110
Phone (386) 236-1726

1220 Willis Ave
Daytona Beach, FL 32114
Phone (386) 236-3200

150 Magnolia Ave
Daytona Beach, FL 32114
Phone (386) 236-3215

1 Anna Marsh Ln
Dummerston, VT 05301

22 Anna Marsh Ln
Dummerston, VT 05301
Phone (802) 258-3700

Organizations & group practices 3

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": "1483315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1366987299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 GROVE AVE",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320843256",
            "telephone_number": "904-615-7669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3406 GLACIER HWY",
            "city": "JUNEAU",
            "state": "AK",
            "postal_code": "998017251",
            "telephone_number": "907-463-3303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEONARDY",
        "first_name": "HEATHER",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-02",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "FL",
            "license": "ARNP9344822",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9344822",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AK",
            "license": "162668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Juneau, AK

Sources for this page

Verify at the official NPI Registry.