North Fort Myers Facility Operations, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

SNF1444096 Issued in FL

Legal business name

NORTH FORT MYERS FACILITY OPERATIONS, LLC

Doing business as

Raydiant Health Care of North Fort Myers

Practice address

991 Pondella Rd
North Fort Myers, FL 33903-3500

Phone

(239) 995-8809

Fax

(239) 995-1253

NPI assigned

Jul 25, 2006

Last updated

Jul 14, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brian Brinkerhoff

Title

Manager

Phone

(407) 429-6100

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Raydiant Health Care of North Fort Myers Doing business as

Electronic endpoints 1

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689292800000",
    "number": "1013930031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "991 PONDELLA RD",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339033500",
            "telephone_number": "239-995-8809",
            "fax_number": "239-995-1253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "991 PONDELLA RD",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339033500",
            "telephone_number": "239-995-8809",
            "fax_number": "239-995-1253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH FORT MYERS FACILITY OPERATIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-25",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A",
        "authorized_official_last_name": "BRINKERHOFF",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "407-429-6100"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "FL",
            "license": "SNF1444096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008040000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://65.196.137.118:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service",
            "affiliation": "Y",
            "endpointDescription": "urn:oid:2.16.840.1.113883.3.5042",
            "affiliationName": "Consulate Healthcare",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "800 Concourse Pkwy S Ste 200",
            "city": "Maitland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "327516148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Raydiant Health Care of North Fort Myers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in North Fort Myers, FL
• Providers in North Fort Myers, FL by specialty
• Skilled Nursing Facility in Florida

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