Lee Kidney Center PA

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

Legal business name

LEE KIDNEY CENTER PA

Practice address

14181 S Tamiami TRL Ste 120a
Fort Myers, FL 33912-1985

Phone

(239) 303-2820

Fax

(239) 303-2511

NPI assigned

Jul 2, 2006

Organization subpart

No

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

Authorized official

Name

Ganesh Shenoy, MDNPI 1881629129

Title

Owner

Phone

(239) 303-2820

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ganesh Shenoy, MD

  • Nephrology Physician
  • Fort Myers, FL
  • NPI 1881629129
  Medicare reassignment NPD Authorized official
• Elaine Lynn Sirt-Hastings

  • Registered Dietitian
  • Fort Myers, FL
  • NPI 1942544978
  NPD (past)

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

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635811200000",
    "number": "1124057989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14181 S TAMIAMI TRL STE 120A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121985",
            "telephone_number": "239-303-2820",
            "fax_number": "239-303-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14181 S TAMIAMI TRL STE 120A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339121985",
            "telephone_number": "239-303-2820",
            "fax_number": "239-303-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE KIDNEY CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2021-11-02",
        "certification_date": "2021-11-02",
        "status": "A",
        "authorized_official_last_name": "SHENOY",
        "authorized_official_first_name": "GANESH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "239-303-2820",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME84882",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lee Health System Inc
• Lee Health System Inc
• Lee Healthcare Inc
• Lee Healthcare Investments, LLC
• Lee Healthcare Investments, LLC
• Lee Med Health Center Inc
• Lee Memorial
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System

• Nephrology Physician in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Nephrology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.