NPIMap

Organization Active NPI

Lee Memorial Health System

Doing business as LCH- Adult Infectious Disease

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
National Provider Identifier
1396471884
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LEE MEMORIAL HEALTH SYSTEM
Doing business as
LCH- Adult Infectious Disease
Practice address
2780 Cleveland Ave Ste 809
Fort Myers, FL 33901-5817
Phone
(239) 343-9680
Fax
(239) 343-4178
NPI assigned
Jul 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2022

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

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2780 Cleveland Ave Ste 809
Fort Myers, FL 33901-5817

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9680

Other names 1

  • LCH- ADULT INFECTIOUS DISEASE Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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": "1396471884",
    "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": "239-343-9680",
            "fax_number": "239-343-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 CLEVELAND AVE STE 809",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339015817",
            "telephone_number": "239-343-9680",
            "fax_number": "239-343-4178"
        }
    ],
    "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 INFECTIOUS DISEASE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 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.