Individual provider Active NPI

Letoya Christian, NP

  • Gerontology Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1154082139
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
APRN11016488 Issued in FL
Practice address
13681 Doctors Way
Fort Myers, FL 33912-4300
Phone
(239) 323-1000
NPI assigned
Jan 3, 2022
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN11016488 FL
Gerontology Nurse Practitioner 363LG0600X APRN11016488 FL Primary

Addresses

Primary practice location

13681 Doctors Way
Fort Myers, FL 33912-4300

Mailing address

PO Box 483
Lehigh Acres, FL 33970-0483
Phone (239) 321-9445

Other practice location 1

13880 Shell Point Plz Ste 110
Fort Myers, FL 33908-3504
Phone (239) 454-2146

Other identifiers 1

IdentifierTypeStateIssuer
113336000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lchristian286057@Direct.leememorial.org Direct Lee Memorial Health System

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
I20220208003010 FL Practitioner - Nurse Practitioner 2365835618 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Axel Health LLC CurrentSince Jan 10, 2022 Accepting new patients
The Christian & Missionary Alliance Foundation Inc Nurse Practitioner CurrentSince Apr 15, 2024 Accepting new patients
The Christian & Missionary Alliance Foundation Inc CurrentSince Apr 15, 2024 Accepting new patients

Locations

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

13880 Shell Point Plz
Ste 110
Fort Myers, FL 33908
Phone (239) 454-2146

15000 Shell Point Blvd
Ste 100
Fort Myers, FL 33908
Phone (813) 454-1111

15051 Shell Point Blvd
Fort Myers, FL 33908
Phone (239) 454-2146

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

8100 Arbor Ct
Fort Myers, FL 33908
Phone (239) 454-2146

Interoperability endpoints

  • Direct secure messaging: lchristian286057@direct.leememorial.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1154082139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 483",
            "city": "LEHIGH ACRES",
            "state": "FL",
            "postal_code": "339700483",
            "telephone_number": "239-321-9445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13681 DOCTORS WAY",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124300",
            "telephone_number": "239-323-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13880 Shell Point Plz Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339083504",
            "country_code": "US",
            "telephone_number": "239-454-2146",
            "fax_number": "239-454-2111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "LETOYA",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11016488",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "FL",
            "license": "APRN11016488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113336000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lchristian286057@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.