Organization Active NPI

Lee Memorial Health System

Doing business as LCH- Peds LHCP

  • Federally Qualified Health Center (FQHC)
  • Estero, FL
National Provider Identifier
1619512803
Registry record updated Mar 27, 2020
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- Peds LHCP
Practice address
23450 Via Coconut PT
Estero, FL 34135-1877
Phone
(239) 468-0150
Fax
(239) 343-4056
NPI assigned
Nov 12, 2019
Last updated
Mar 27, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2020

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

23450 Via Coconut PT
Estero, FL 34135-1877

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 468-0150

Other names 1

  • LCH- PEDS LHCP 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": "1573516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585267200000",
    "number": "1619512803",
    "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": "239-468-0150",
            "fax_number": "239-343-4056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23450 VIA COCONUT PT",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "341351877",
            "telephone_number": "239-468-0150",
            "fax_number": "239-343-4056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-12",
        "last_updated": "2020-03-27",
        "certification_date": "2020-03-27",
        "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- PEDS LHCP",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LCH- PEDS LHCP",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2020; 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.