Individual provider Active NPI

Christine Arminda Fordham, M.D.

  • Pediatric Otolaryngology Physician
  • Fort Myers, FL
National Provider Identifier
1427316231
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
ME150942 Issued in FL
Practice address
16230 Summerlin Rd Ste 215
Fort Myers, FL 33908-5769
Phone
(239) 343-6050
Fax
(239) 343-4190
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X MD2017-0816 NM
Student in an Organized Health Care Education/Training Program 390200000X
Pediatric Otolaryngology Physician 207YP0228X ME150942 FL Primary

Addresses

Primary practice location

16230 Summerlin Rd Ste 215
Fort Myers, FL 33908-5769

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1500

Other practice location 1

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (619) 543-6444

Other identifiers 1

IdentifierTypeStateIssuer
110539600MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD2017-0816NMMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Nemours Foundation Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cfordham267424@direct.leememorial.org
  • Direct secure messaging: cfordham118037@direct.nemours.org

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1427316231",
    "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": "239-424-1500",
            "fax_number": "239-424-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16230 SUMMERLIN RD STE 215",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339085769",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 W Arbor Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921039000",
            "country_code": "US",
            "telephone_number": "619-543-6444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORDHAM",
        "first_name": "CHRISTINE",
        "middle_name": "ARMINDA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "NM",
            "license": "MD2017-0816",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "FL",
            "license": "ME150942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110539600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 May 18, 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.