Individual provider Active NPI

Alec Leyendecker

  • Registered Nurse
  • Hamilton, OH
National Provider Identifier
1760053227
Registry record updated Jul 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN.477996 Issued in OH
Practice address
1910 Fairgrove Ave Ste E
Hamilton, OH 45011-1930
Phone
(513) 795-7557
NPI assigned
Jul 6, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN.477996 OH Primary

Addresses

Primary practice location

1910 Fairgrove Ave Ste E
Hamilton, OH 45011-1930

Mailing address

1910 Fairgrove Ave Ste E
Hamilton, OH 45011-1930
Phone (513) 795-7557

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
RN.477996OHMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Modern Psychiatry and Wellness LLC CurrentSince Jul 17, 2021 Accepting new patients
Modern Psychiatry & Wellness, LLC CurrentSince Jul 17, 2021 Accepting new patients

Locations

1910 Fairgrove Ave
Ste E
Hamilton, OH 45011
Phone (513) 299-4025

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
  • FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/r4/

Organizations & group practices 2

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": "1625529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625529600000",
    "number": "1760053227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 FAIRGROVE AVE STE E",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450111930",
            "telephone_number": "513-795-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 FAIRGROVE AVE STE E",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450111930",
            "telephone_number": "513-795-7557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEYENDECKER",
        "first_name": "ALEC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-06",
        "last_updated": "2021-07-06",
        "certification_date": "2021-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN.477996",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2021; 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.