Lee Memorial Health System

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

LEE MEMORIAL HEALTH SYSTEM

Doing business as

LCH IM Matthew Dr
LCH-Internal Medicine Matthew Drive

Practice address

1569 Matthew Dr
Fort Myers, FL 33907-1734

Phone

(239) 343-8220

Fax

(239) 468-7909

NPI assigned

Aug 18, 2023

Organization subpart

No

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

Authorized official

Name

Joseph Niebergall

Title

Credentialing Specialist

Phone

(239) 424-1446

Specialties & licenses 1

Addresses

Other names 2

• LCH IM Matthew Dr Doing business as
• LCH-Internal Medicine Matthew Drive Doing business as

Locations

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

{
    "created_epoch": "1692316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1694649600000",
    "number": "1013790393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-8220",
            "fax_number": "239-468-7909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1569 MATTHEW DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071734",
            "telephone_number": "239-343-8220",
            "fax_number": "239-468-7909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-18",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A",
        "authorized_official_last_name": "NIEBERGALL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "239-424-1446"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCH IM Matthew Dr",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LCH-Internal Medicine Matthew Drive",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lee Healthcare Investments, LLC (Lee Health Surgery Center - General Surgery)
• Lee Kidney Center PA
• Lee Med Health Center Inc
• Lee Memorial
• Lee Memorial Health System (LCH- Peds Page Field)
• Lee Memorial Health System (Lee Memorial Hospital Pharmacy)
• Lee Memorial Health System (LCH-Adult Endocrinology)
• Lee Memorial Health System (Gulf Coast Skilled Nursing Unit)
• Lee Memorial Health System (LCH-Pediatric Neurological Health)
• Lee Memorial Health System

• Federally Qualified Health Center (FQHC) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.