Individual provider Active NPI

Natoya A Queenbourrows, NURSE PRACTITIONER

  • Psychiatric/Mental Health Nurse Practitioner
  • Port St Lucie, FL
National Provider Identifier
1639685266
Registry record updated Jan 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
9366533 Issued in FL
Practice address
1230 NW Leonardo Cir
Port St Lucie, FL 34986-4343
Phone
(772) 224-5654
NPI assigned
Dec 19, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X 9366533 FL Primary
Family Medicine Physician 207Q00000X ARNP9366533 FL
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X 9366533 FL

Addresses

Primary practice location

1230 NW Leonardo Cir
Port St Lucie, FL 34986-4343

Mailing address

1230 NW Leonardo Cir
Port St Lucie, FL 34986-4343

Other practice location 1

2505 Metrocentre Blvd
West Palm Beach, FL 33407-3114
Phone (561) 201-1516

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, GA2 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
I20231127003366 FL Practitioner - Nurse Practitioner 2264880558
I20241017000574 GA Practitioner - Nurse Practitioner 2264880558 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
ARNP9366533FLMDFamily Medicine Physician
9366533FLMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Internal Medicine and Psychiatric Care Multi-Specialty CurrentSince Sep 26, 2024 Accepting new patients
Genpsych, LLC CurrentSince Oct 10, 2021 Accepting new patients
Genpsych Personal Care Current Accepting new patients

Locations

2505 Metrocentre Blvd
Ste 300
West Palm Beach, FL 33407
Phone (561) 478-2003

2505 Metrocentre Blvd
West Palm Beach, FL 33407
Phone (561) 201-1516

3915 Cascade Rd SW
Ste 360
Atlanta, GA 30331
Phone (404) 291-0416

1065 US Highway 22
Ste 3
Bridgewater, NJ 08807
Phone (908) 526-8370

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769385600000",
    "number": "1639685266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 NW LEONARDO CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349864343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 NW LEONARDO CIR",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349864343",
            "telephone_number": "772-224-5654"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2505 Metrocentre Blvd",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334073114",
            "country_code": "US",
            "telephone_number": "561-201-1516",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "QUEENBOURROWS",
        "first_name": "NATOYA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-19",
        "last_updated": "2026-01-26",
        "certification_date": "2026-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "9366533",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ARNP9366533",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "9366533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port St Lucie, FL

Sources for this page

Verify at the official NPI Registry.