NPIMap

Organization Active NPI

Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
National Provider Identifier
1124621339
Registry record updated Jan 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LEE MEMORIAL HEALTH SYSTEM
Practice address
15901 Bass Rd Ste 108
Fort Myers, FL 33908-3838
Phone
(239) 343-6050
Fax
(239) 343-6051
NPI assigned
Nov 19, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2021

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

Authorized official

Name
Joseph Niebergall
Title
Credentialing Specialist
Phone
(239) 424-1446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

15901 Bass Rd Ste 108
Fort Myers, FL 33908-3838

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1449

Other names 1

  • LCH-PEDIATRIC NEUROLOGICAL HEALTH Doing business as

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1610928000000",
    "number": "1124621339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-424-1449",
            "fax_number": "239-424-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15901 BASS RD STE 108",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083838",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-19",
        "last_updated": "2021-01-18",
        "certification_date": "2021-01-18",
        "status": "A",
        "authorized_official_last_name": "NIEBERGALL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "239-424-1446"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCH-PEDIATRIC NEUROLOGICAL HEALTH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 18, 2021; 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.