Lighthouse Pediatrics of Naples, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME076050 Issued in FL

Legal business name

LIGHTHOUSE PEDIATRICS OF NAPLES, LLC

Practice address

3227 Horseshoe Dr S
Naples, FL 34104-6114

Phone

(239) 449-9882

Fax

(239) 449-9884

NPI assigned

Jan 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Debra Goodridge Shepard, M.D.NPI 1619918711

Title

Doctor/Practice Co-Owner

Phone

(239) 449-9882

Specialties & licenses 2

Addresses

Other identifiers 6

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 4

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

• Debra G Shepard, MD

  • Pediatrics Physician
  • Naples, FL
  • NPI 1619918711
  NPD (past) Authorized official
• Alexis Napoleon Fernandez, MD

  • Pediatrics Physician
  • Sarasota, FL
  • NPI 1659722296
  NPD (past)
• Blanca Estela Hernandez, APRN

  • Family Nurse Practitioner
  • Naples, FL
  • NPI 1306462254
  NPD (past)
• Traci Viau, ARNP

  • Pediatric Nurse Practitioner
  • Naples, FL
  • NPI 1528200284
  NPD (past)

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421107200000",
    "number": "1285023309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3227 HORSESHOE DR S",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341046114",
            "telephone_number": "239-449-9882",
            "fax_number": "239-449-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 HORSESHOE DR S",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341046114",
            "telephone_number": "239-449-9882",
            "fax_number": "239-449-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIGHTHOUSE PEDIATRICS OF NAPLES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-13",
        "last_updated": "2015-01-13",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "GOODRIDGE",
        "authorized_official_title_or_position": "DOCTOR/PRACTICE CO-OWNER",
        "authorized_official_telephone_number": "239-449-9882",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME076050",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "FL",
            "license": "ME0053566",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "07336",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "254504700",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "43843",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "048604300",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1043264302",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1619918711",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Life Forever Medical & Rehab Center Inc
• Life Hearing and Audiology Clinics (Life Hearing Health Centers)
• Lifecare 2-3 LLC (LifeCare Hospital of Naples)
• Lifestrength Family Chiropractic, PLLC
• Lifestyle Healing Institute LLC
• Lighthouse Therapy Group, PLLC
• Lightning Home Health Care LLC
• Kristen Lillie, P.T.
• James S Lim, M.D.
• Yearin Lim

• Pediatrics Physician in Naples, FL
• Providers in Naples, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.