Active NPI
John Alexander Churchill, M.D.
- Orthopaedic Surgery Physician
- Ft. Myers, FL
National Provider Identifier
1245244995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- ME87100
- Practice address
- 15821 Hollyfern CT
Ft. Myers, FL 33908 - Phone
- (239) 432-5100
- Fax
- (239) 432-0629
- NPI assigned
- Jul 28, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | ME87100 | FL | Primary |
Addresses
Primary practice location
15821 Hollyfern CT
Ft. Myers, FL 33908
Mailing address
15880 Summerlin Rd
Ste 300 PMB 322
Fort Myers, FL 33908-9612
Phone (239) 432-5100
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 221101 | Other | FL | STAYWELL HEALTHY KIDS |
| 270843 | Other | FL | AVMED |
| 7566688-008 | Other | FL | CIGNA |
| 189182 | Other | FL | AMERIGROUP |
| 25519 | Other | FL | BLUE CROSS BLUE SHIELD |
| 4509387 | Other | FL | AETNA |
| 267883700 | Medicaid | FL |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME87100 | FL | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154044800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1347580800000",
"number": "1245244995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15880 SUMMERLIN RD",
"address_2": "STE 300 PMB 322",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "339089612",
"telephone_number": "239-432-5100",
"fax_number": "239-432-0629"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15821 HOLLYFERN CT",
"city": "FT. MYERS",
"state": "FL",
"postal_code": "33908",
"telephone_number": "239-432-5100",
"fax_number": "239-432-0629"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURCHILL",
"first_name": "JOHN",
"middle_name": "ALEXANDER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-28",
"last_updated": "2012-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "FL",
"license": "ME87100",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STAYWELL HEALTHY KIDS",
"identifier": "221101",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AVMED",
"identifier": "270843",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7566688-008",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP",
"identifier": "189182",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "25519",
"state": "FL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4509387",
"state": "FL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "267883700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ft. 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, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.