NPIMap

Organization Active NPI

Elevate Medical Fort Myers, LLC

  • Multi-Specialty Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1306461447
Registry record updated Jun 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
ELEVATE MEDICAL FORT MYERS, LLC
Practice address
1850 Boy Scout Dr Ste A102
Fort Myers, FL 33907-2127
Phone
(870) 919-6686
Fax
(662) 560-0161
NPI assigned
Jun 15, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 15, 2020

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

Authorized official

Name
Jeremy Mitchell, BSN
Title
Owner
Phone
(870) 919-6686

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1850 Boy Scout Dr Ste A102
Fort Myers, FL 33907-2127

Mailing address

1850 Boy Scout Dr Ste A102
Fort Myers, FL 33907-2127
Phone (662) 501-0043

Other names 1

  • Elevate Medical Fort Myers, LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

1850 Boy Scout Dr
Ste A102
Fort Myers, FL 33907
Phone (870) 919-6686

NPI Registry JSON

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

{
    "created_epoch": "1592179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592179200000",
    "number": "1306461447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1850 BOY SCOUT DR STE A102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072127",
            "telephone_number": "662-501-0043",
            "fax_number": "662-560-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 BOY SCOUT DR STE A102",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072127",
            "telephone_number": "870-919-6686",
            "fax_number": "662-560-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELEVATE MEDICAL FORT MYERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-15",
        "last_updated": "2020-06-15",
        "certification_date": "2020-06-15",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-919-6686",
        "authorized_official_credential": "BSN"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Elevate Medical Fort Myers, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 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.