NPIMap

Organization Active NPI

Lee Memorial Health System

Doing business as LCH- Adult Gastroenterology

  • Federally Qualified Health Center (FQHC)
  • Fort Myers, FL
National Provider Identifier
1548997984
Registry record updated Jan 18, 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- Adult Gastroenterology
Practice address
9800 S Healthpark Dr Ste 110
Fort Myers, FL 33908-3630
Phone
(239) 343-6202
Fax
(239) 437-4159
NPI assigned
Aug 5, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

9800 S Healthpark Dr Ste 110
Fort Myers, FL 33908-3630

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6202

Other practice location 1

16410 Healthpark Commons Dr
Fort Myers, FL 33908-9621
Phone (239) 343-6202

Other names 1

  • LCH- ADULT GASTROENTEROLOGY 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": "1659657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674000000000",
    "number": "1548997984",
    "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": "239-343-6202",
            "fax_number": "239-437-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 S HEALTHPARK DR STE 110",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083630",
            "telephone_number": "239-343-6202",
            "fax_number": "239-437-4159"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16410 Healthpark Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339089621",
            "country_code": "US",
            "telephone_number": "239-343-6202",
            "fax_number": "239-437-4159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-05",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "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 GASTROENTEROLOGY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LCH- ADULT GASTROENTEROLOGY",
            "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 Jan 18, 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.