Individual provider Active NPI

Wilmyne Leger, LPN

  • Nurse Practitioner
  • Mesa, AZ
National Provider Identifier
1821388406
Registry record updated Jan 11, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN11027643 Issued in FL
Practice address
6015 E Brown Rd
Mesa, AZ 85205-4452
Phone
(866) 389-2727
NPI assigned
Apr 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2026

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0036388 OH
Family Nurse Practitioner 363LF0000X 327995 AZ
Family Medicine Physician 207Q00000X 84990 NM
Family Medicine Physician 207Q00000X C-APN.0104711-C-NP CO
Family Medicine Physician 207Q00000X AP70026484 WA
Nurse Practitioner 363L00000X APRN11027643 FL Primary

Addresses

Primary practice location

6015 E Brown Rd
Mesa, AZ 85205-4452

Mailing address

15280 NW 79TH CT Ste 200
Miami Lakes, FL 33016-5873
Phone (305) 558-3724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240521003237 FL Practitioner - Nurse Practitioner 6002258134 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C-APN.0104711-C-NPCOMDFamily Medicine Physician
84990NMMDFamily Medicine Physician
0036388OHMDFamily Medicine Physician
AP70026484WAMDFamily Medicine Physician
327995AZMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Swallowing Diagnostics Inc CurrentSince Apr 9, 2024 Accepting new patients
Vitality Ageless Center LLC Family Medicine CurrentSince Jun 11, 2024 Accepting new patients

Locations

555 W Granada Blvd
Ste E2
Ormond Beach, FL 32174
Phone (386) 235-6136

1300 Peachtree Industrial Blvd
Ste 1201
Suwanee, GA 30024
Phone (770) 614-6266

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": "1302825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768089600000",
    "number": "1821388406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15280 NW 79TH CT STE 200",
            "city": "MIAMI LAKES",
            "state": "FL",
            "postal_code": "330165873",
            "telephone_number": "305-558-3724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6015 E BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852054452",
            "telephone_number": "866-389-2727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGER",
        "first_name": "WILMYNE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-15",
        "last_updated": "2026-01-11",
        "certification_date": "2026-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "0036388",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "327995",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NM",
            "license": "84990",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "C-APN.0104711-C-NP",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "AP70026484",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11027643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.