Active NPI
Linda Lee Marcellus
- In Home Supportive Care Agency
- Fort Myers, FL
National Provider Identifier
1104431469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- Practice address
- 15196 Harbour Isle Dr
Fort Myers, FL 33908-6809 - Phone
- (330) 283-6621
- NPI assigned
- Sep 14, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Primary |
Addresses
Primary practice location
15196 Harbour Isle Dr
Fort Myers, FL 33908-6809
Mailing address
15196 Harbour Isle Dr
Fort Myers, FL 33908-6809
Phone (330) 283-6621
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5200375 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600041600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600041600000",
"number": "1104431469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15196 HARBOUR ISLE DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339086809",
"telephone_number": "330-283-6621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15196 HARBOUR ISLE DR",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339086809",
"telephone_number": "330-283-6621"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCELLUS",
"first_name": "LINDA",
"middle_name": "LEE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-14",
"last_updated": "2020-09-14",
"certification_date": "2020-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "5200375",
"state": "OH"
}
],
"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 Sep 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.