Individual provider Active NPI

Jaleesa Dkendra Jegede, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Southlake, TX
National Provider Identifier
1639713035
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
AP143772 Issued in TX
Practice address
1100 E Southlake Blvd Ste 200
Southlake, TX 76092-6381
Phone
(817) 756-1293
NPI assigned
Oct 30, 2019
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 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 AP143772 TX Primary

Addresses

Primary practice location

1100 E Southlake Blvd Ste 200
Southlake, TX 76092-6381

Mailing address

1100 E Southlake Blvd Ste 200
Southlake, TX 76092-6381
Phone (936) 615-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20191220000398 TX Practitioner - Nurse Practitioner 7719311075 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP143772TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Connections Wellness Group CurrentSince May 25, 2025 Accepting new patients
Bent Tree Medicine, PLLC CurrentSince Dec 1, 2019 Accepting new patients
Connections Physicians Group CurrentSince Oct 3, 2025 Accepting new patients

Locations

4907 S Collins St
Ste 121
Arlington, TX 76018
Phone (817) 417-9001

2711 Shoreline Dr
Ste 121
Denton, TX 76210

2800 Shoreline Dr
Ste 290
Denton, TX 76210
Phone (615) 393-6746

3312 Teasley Ln
Ste 100
Denton, TX 76210
Phone 88874742948311

2560 Central Park Ave
Ste 200
Flower Mound, TX 75028
Phone (940) 289-4569

9726 N Beach St
Fort Worth, TX 76244
Phone (817) 770-0208

255 W Lebanon
Ste 120
Frisco, TX 75036
Phone (469) 430-1930

1900 Matlock Rd
Bldg 2
Mansfield, TX 76063
Phone (817) 312-6458

6045 Alma Rd
Ste 210
McKinney, TX 75070
Phone (972) 893-3376

7290 Virginia Pkwy
Ste 2100
McKinney, TX 75071

6101 W Plano Pkwy
Ste 230
Plano, TX 75093
Phone (469) 613-3390

6101 W Plano Pkwy
Ste 240
Plano, TX 75093
Phone (469) 312-2107

6839 Communications Pkwy
Plano, TX 75024
Phone (469) 379-8222

1005 W Ralph Hall Pkwy
Ste 201
Rockwall, TX 75032
Phone (888) 990-0663

1100 E Southlake Blvd
Ste 200
Southlake, TX 76092
Phone (817) 697-4195

141 Jd Towles Dr
Willow Park, TX 76087
Phone (210) 668-0301

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": "1572393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1639713035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E SOUTHLAKE BLVD STE 200",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926381",
            "telephone_number": "936-615-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E SOUTHLAKE BLVD STE 200",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926381",
            "telephone_number": "817-756-1293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEGEDE",
        "first_name": "JALEESA",
        "middle_name": "DKENDRA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-30",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP143772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

Verify at the official NPI Registry.