Individual provider Active NPI

Joel Vansickler, M.D.

  • Nephrology Physician
  • Ft Myers, FL
National Provider Identifier
1245281864
Registry record updated Aug 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
ME54727 Issued in FL
Practice address
7981 Gladiolus Dr
Ft Myers, FL 33908-4154
Phone
(239) 939-0999
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X ME54727 FL Primary
Specialist 174400000X ME 54727 FL

Addresses

Primary practice location

7981 Gladiolus Dr
Ft Myers, FL 33908-4154

Mailing address

7981 Gladiolus Dr
Ft Myers, FL 33908-4154

Other names 1

  • Dr. Joel Vansickler Other name

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

LicenseStateTypeSpecialty
ME 54727FLMDSpecialist
ME54727FLMDNephrology Physician

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598313600000",
    "number": "1245281864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7981 GLADIOLUS DR",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339084154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7981 GLADIOLUS DR",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339084154",
            "telephone_number": "239-939-0999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANSICKLER",
        "first_name": "JOEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-25",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "FL",
            "license": "ME54727",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME 54727",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOEL",
            "last_name": "VANSICKLER",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Aug 25, 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.

Verify at the official NPI Registry.