NPIMap

Organization Active NPI

Lee Memorial Health System

Doing business as LCH - Pediatric ENT

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
National Provider Identifier
1548840838
Registry record updated Dec 13, 2023
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 - Pediatric ENT
Practice address
16410 Healthpark Commons Dr
Fort Myers, FL 33908-9621
Phone
(239) 343-7474
Fax
(239) 343-4190
NPI assigned
Apr 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Authorized official

Name
James Fores
Title
Credentialing Specialist
Phone
(239) 424-1479

Specialties & licenses 1

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

Addresses

Primary practice location

16410 Healthpark Commons Dr
Fort Myers, FL 33908-9621

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-1449

Other practice location 1

16230 Summerlin Rd Ste 215
Fort Myers, FL 33908-5769
Phone (239) 343-6050

Other names 1

  • LCH - PEDIATRIC ENT 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": "1618012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702425600000",
    "number": "1548840838",
    "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": "239-424-1449",
            "fax_number": "239-424-1423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16410 HEALTHPARK COMMONS DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339089621",
            "telephone_number": "239-343-7474",
            "fax_number": "239-343-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16230 Summerlin Rd Ste 215",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339085769",
            "country_code": "US",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-6136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-10",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A",
        "authorized_official_last_name": "FORES",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "239-424-1479"
    },
    "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 - PEDIATRIC ENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LCH - PEDIATRIC ENT",
            "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 Dec 13, 2023; 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.