Lee Memorial Health System

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

LEE MEMORIAL HEALTH SYSTEM

Practice address

12600 Creekside LN Ste 2
Fort Myers, FL 33919-3353

Phone

(239) 343-9235

Fax

(239) 343-4008

NPI assigned

Jul 27, 2022

Organization subpart

No

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

Addresses

Other names 1

• LCH-ADULT NEUROLOGY Doing business as

Member of 1

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

• Lee Memorial Health System

  • General Practice Physician
  • Cape Coral, FL
  • NPI 1902379209

  Member Of

  NPD member

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

{
    "created_epoch": "1658880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658880000000",
    "number": "1265168751",
    "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": "239-343-9235",
            "fax_number": "239-343-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 CREEKSIDE LN STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193353",
            "telephone_number": "239-343-9235",
            "fax_number": "239-343-4008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-27",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "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-ADULT NEUROLOGY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System
• Lee Memorial Health System

• Federally Qualified Health Center (FQHC) in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Federally Qualified Health Center (FQHC) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2022; 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.