Organization Active NPI

Mark X Norleans MD PHD PA

  • Internal Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1487717062
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARK X NORLEANS MD PHD PA
Practice address
9730 Commerce Center Court
Fort Myers, FL 33908-3615
Phone
(239) 482-5003
Fax
(239) 989-0166
NPI assigned
Dec 18, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Authorized official

Name
Mark X. NorleansNPI 1841211208
Title
President
Phone
(239) 482-5003

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

9730 Commerce Center Court
Fort Myers, FL 33908-3615

Mailing address

9730 Commerce Center Court
Fort Myers, FL 33908-3615
Phone (239) 482-5003

Other identifiers 2

IdentifierTypeStateIssuer
ME86281OtherFLLICENSE
P00017745OtherFLRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070228000198 FL Part B Supplier - Clinic/Group Practice 9133221781 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Myers, FL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D1059645Mark X Norleans MD PHD PA9730 Commerce Ctr CT, Fort Myers, FL 33908Certificate of waiverOct 3, 2026

National Provider Directory

National Provider Directory

Locations

9730 Commerce Center Ct
Fort Myers, FL 33908
Phone (239) 482-5003

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1487717062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9730 COMMERCE CENTER COURT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083615",
            "telephone_number": "239-482-5003",
            "fax_number": "239-989-0166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 COMMERCE CENTER COURT",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083615",
            "telephone_number": "239-482-5003",
            "fax_number": "239-989-0166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK X NORLEANS MD PHD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "NORLEANS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "X.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-482-5003"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "ME86281",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00017745",
            "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 Sep 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.