Individual provider Active NPI

Andreana Leggett

  • Family Nurse Practitioner
  • Titusville, FL
National Provider Identifier
1912770504
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10230997 Issued in FL
Practice address
951 N Washington Ave
Titusville, FL 32796-2163
Phone
(321) 289-6636
NPI assigned
Nov 6, 2023
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F10230997 FL Primary

Addresses

Primary practice location

951 N Washington Ave
Titusville, FL 32796-2163

Mailing address

725 Everglades CT
Titusville, FL 32780-6450
Phone (321) 289-6636

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
I20240118000248 FL Practitioner - Nurse Practitioner 7113379876 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Brevard Medical Support IncGroup PAC ID 7618870296, 62 clinicians

Practice addresses (Care Compare)

250 Harrison St
Titusville, FL 32780-5094
Phone (321) 268-6834

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F10230997FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Brevard Medical Support, Inc CurrentSince Jan 1, 2024 Accepting new patients

Locations

250 Harrison St
Titusville, FL 32780
Phone (321) 268-6868

951 N Washington Ave
Titusville, FL 32796
Phone (302) 325-5511

Interoperability endpoints

  • Direct secure messaging: andreana.leggett.1@17832.direct.athenahealth.com

Organizations & group practices 1

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1699228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1912770504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 EVERGLADES CT",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327806450",
            "telephone_number": "321-289-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 N WASHINGTON AVE",
            "city": "TITUSVILLE",
            "state": "FL",
            "postal_code": "327962163",
            "telephone_number": "321-289-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEGGETT",
        "first_name": "ANDREANA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-06",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "F10230997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Titusville, FL

Sources for this page

Verify at the official NPI Registry.