Organization Active NPI

Florida Community Health Partners

  • Family Medicine Physician
  • Fort Myers, FL
National Provider Identifier
1619711363
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FLORIDA COMMUNITY HEALTH PARTNERS
Practice address
8140 College Pkwy Ste 101
Fort Myers, FL 33919-5189
Phone
(239) 202-8128
NPI assigned
Jun 19, 2024
Last updated
Jul 28, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Authorized official

Name
Katie Johnson
Title
Director of Operations
Phone
(484) 769-4369

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X

Addresses

Primary practice location

8140 College Pkwy Ste 101
Fort Myers, FL 33919-5189

Mailing address

8140 College Pkwy Ste 101
Fort Myers, FL 33919-5189
Phone (239) 202-8128

Other practice location 1

4648 E County Road 540A
Lakeland, FL 33813-4472
Phone (863) 213-0365

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240820003599 FL Part B Supplier - Clinic/Group Practice 8921546094 Receives reassigned benefits from 6 practitioners
1 other NPI on this enrollment
Practice locations: Fort Lauderdale, FL; Fort Myers, FL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
10D2302397Florida Community Health Partners LLC8140 College Pkwy - Ste 101, Fort Myers, FL 33919Certificate of waiverApr 9, 2028
10D2319661Florida Community Health Partners, LLC4648 E County Road 540a, Lakeland, FL 33813Certificate of waiverMar 4, 2027

National Provider Directory

National Provider Directory

Locations

5231 NW 33rd Ave
Ft Lauderdale, FL 33309
Phone (239) 202-8128

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1718755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1619711363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8140 COLLEGE PKWY STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195189",
            "telephone_number": "239-202-8128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8140 COLLEGE PKWY STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339195189",
            "telephone_number": "239-202-8128"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4648 E County Road 540A",
            "address_purpose": "LOCATION",
            "city": "Lakeland",
            "state": "FL",
            "postal_code": "338134472",
            "country_code": "US",
            "telephone_number": "863-213-0365",
            "fax_number": "239-202-8128",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "FLORIDA COMMUNITY HEALTH PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-19",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KATIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "484-769-4369"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Jul 28, 2026; 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.