Active NPI
Linda Yarris-Ewert PHD MD PA
- Family Medicine Physician
- Fort Myers, FL
National Provider Identifier
1053557124
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 0064852
- Legal business name
- LINDA YARRIS-EWERT PHD MD PA
- Practice address
- 12545 New Brittany Blvd
Fort Myers, FL 33907-3625 - Phone
- (239) 274-2071
- NPI assigned
- Dec 19, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Linda Marian Yarris-Ewert, PHD, MD
- Title
- Physician/Owner
- Phone
- (239) 274-2071
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 0064852 | FL | Primary |
Addresses
Primary practice location
12545 New Brittany Blvd
Fort Myers, FL 33907-3625
Mailing address
12545 New Brittany Blvd
Fort Myers, FL 33907-3625
Phone (239) 274-2071
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 374409400 | Other | FL | MEDICAID |
| AS19990440001 | Other | FL | CIGNA INSURANCE |
| 194736 | Other | FL | STAYWELL HEALTHY KIDS |
| 23801 | Other | FL | BLUE CROSS BLUE SHIELD |
| 2666792 | Other | FL | AETNA HEALTHCARE |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229644800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1231286400000",
"number": "1053557124",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12545 NEW BRITTANY BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073625",
"telephone_number": "239-274-2071"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12545 NEW BRITTANY BLVD",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339073625",
"telephone_number": "239-274-2071"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LINDA YARRIS-EWERT PHD MD PA",
"organizational_subpart": "NO",
"enumeration_date": "2008-12-19",
"last_updated": "2009-01-07",
"status": "A",
"authorized_official_last_name": "YARRIS-EWERT",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "MARIAN",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "239-274-2071",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PHD, MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": "FL",
"license": "0064852",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID",
"identifier": "374409400",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA INSURANCE",
"identifier": "AS19990440001",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STAYWELL HEALTHY KIDS",
"identifier": "194736",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "23801",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HEALTHCARE",
"identifier": "2666792",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Myers, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.