Jaclyn E.a. Legg, D.O.

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

0539323 Issued in KS

Practice address

4121 W 83Rd St Ste 254
Prairie Village, KS 66208-5303

Phone

(913) 291-0076

Fax

(913) 951-0656

NPI assigned

Jun 21, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 30, 2025 through Jul 30, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Monarch Mental Health LLC

  • Child & Adolescent Psychiatry Physician
  • Prairie Village, KS
  • NPI 1992466072
  NPD (past)
• Psychpros of Kansas City

  • Mental Health Counselor
  • Lee's Summit, MO
  • NPI 1629529888
  NPD (past)

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689638400000",
    "number": "1558624890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4121 W 83RD ST STE 254",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085303",
            "telephone_number": "913-291-0076",
            "fax_number": "913-951-0656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4121 W 83RD ST STE 254",
            "city": "PRAIRIE VILLAGE",
            "state": "KS",
            "postal_code": "662085303",
            "telephone_number": "913-291-0076",
            "fax_number": "913-951-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGG",
        "first_name": "JACLYN",
        "middle_name": "E.A.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-21",
        "last_updated": "2023-07-18",
        "certification_date": "2023-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0539323",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "KS",
            "license": "0539323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Sue Laughlin, PTA
• Corey Leach, DPT
• Wesley Max Ledom, PH.D.
• Elijah Lee, PHD
• Laura Lefkowitz Bratt, M.A.
• Joanna Marie Leonard
• Amanda Leoni, LCSW, LSCSW
• Bruce E Lerner, M.D.
• Leslie a Abbey, L.L.C.
• Jaimie Marie Levin, D.V.M.

• Child & Adolescent Psychiatry Physician in Prairie Village, KS
• Providers in Prairie Village, KS by specialty
• Child & Adolescent Psychiatry Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.