Individual provider Active NPI

Priscilla Muthoni Ndiangui, APRN

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1073855615
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9241697 Issued in FL
Practice address
14350 Metropolis Ave Ste 1
Fort Myers, FL 33912-4430
Phone
(239) 275-3036
Fax
(239) 275-8480
NPI assigned
Mar 21, 2013
Last updated
Jun 22, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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 ARNP9241697 FL Primary

Addresses

Primary practice location

14350 Metropolis Ave Ste 1
Fort Myers, FL 33912-4430

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (877) 856-3774

Other practice location 1

930 S Main St
LaBelle, FL 33935-4448
Phone (863) 674-5520

Other identifiers 1

IdentifierTypeStateIssuer
008709200MedicaidFL

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
I20130625000422 FL Practitioner - Nurse Practitioner 4587803416 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

23450 Via Coconut PT
Estero, FL 34135-1877
Phone (239) 468-0120

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Mar 7, 2022 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 7, 2022 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

23450 Via Coconut Pt
Estero, FL 34135
Phone (239) 468-0150

14350 Metropolis Ave
Ste 1
Fort Myers, FL 33912
Phone (239) 275-3036

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

8960 Colonial Center Dr
Ste 300
Fort Myers, FL 33905
Phone (239) 343-9470

930 S Main St
Labelle, FL 33935
Phone (239) 343-3831

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

Interoperability endpoints

  • Direct secure messaging: pndiangui81289@direct.leememorial.org

Organizations & group practices 5

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655856000000",
    "number": "1073855615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "877-856-3774",
            "fax_number": "239-275-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14350 METROPOLIS AVE STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124430",
            "telephone_number": "239-275-3036",
            "fax_number": "239-275-8480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "930 S Main St",
            "address_purpose": "LOCATION",
            "city": "LaBelle",
            "state": "FL",
            "postal_code": "339354448",
            "country_code": "US",
            "telephone_number": "863-674-5520",
            "fax_number": "863-674-5521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NDIANGUI",
        "first_name": "PRISCILLA",
        "middle_name": "MUTHONI",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9241697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "008709200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.