NPIMap

Organization Active NPI

Agency for Persons With Disabilities

  • Intellectual Disabilities Intermediate Care Facility
  • Ft Myers, FL
National Provider Identifier
1245398361
Registry record updated Jun 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
Legal business name
AGENCY FOR PERSONS WITH DISABILITIES
Practice address
5820 Buckingham Road
Ft Myers, FL 33905-7413
Phone
(239) 690-3662
Fax
(239) 694-5802
NPI assigned
Dec 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2008

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

Authorized official

Name
Mr. Michael S Mayfield
Title
Center Administrator
Phone
(239) 690-3652

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X Primary

Addresses

Primary practice location

5820 Buckingham Road
Ft Myers, FL 33905-7413

Mailing address

5820 Buckingham Road
Ft Myers, FL 33905-7413
Phone (239) 694-2151

Other identifiers 6

IdentifierTypeStateIssuer
0280089-00MedicaidFL
0280127-00MedicaidFL
0280224-00MedicaidFL
0280135-00MedicaidFL
0280178-00MedicaidFL
0280011-00MedicaidFL

Other names 1

  • Gulf Coast Center ICF DD - State of Fl Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Agency for Persons With Disabilities12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5820 Buckingham Rd
Fort Myers, FL 33905
Phone (239) 694-2151

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1245398361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5820 BUCKINGHAM ROAD",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339057413",
            "telephone_number": "239-694-2151",
            "fax_number": "239-694-6231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5820 BUCKINGHAM ROAD",
            "city": "FT MYERS",
            "state": "FL",
            "postal_code": "339057413",
            "telephone_number": "239-690-3662",
            "fax_number": "239-694-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGENCY FOR PERSONS WITH DISABILITIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "MAYFIELD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CENTER ADMINISTRATOR",
        "authorized_official_telephone_number": "239-690-3652",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280089-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280127-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280224-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280135-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280178-00",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0280011-00",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gulf Coast Center ICF DD - State of Fl",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 18, 2008; 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.