Individual provider Active NPI

Nicole J Thompson, APN

  • Adult Health Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1639115355
Registry record updated Jun 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
APRN10000898 Issued in FL
Practice address
12600 Creekside LN Ste 2
Fort Myers, FL 33919-3353
Phone
(239) 343-9235
Fax
(239) 343-4008
NPI assigned
Jun 21, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APN0000012022 TN
Adult Health Nurse Practitioner 363LA2200X APRN10000898 FL Primary

Addresses

Primary practice location

12600 Creekside LN Ste 2
Fort Myers, FL 33919-3353

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-9235

Other practice location 1

9314 Park West Blvd
Suite 200
Knoxville, TN 37923-4330
Phone (865) 694-0577

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190206000094 FL Practitioner - Nurse Practitioner 6507860731 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lee Health System IncGroup PAC ID 9335672146, 1,381 clinicians

Practice addresses (Care Compare)

1138 Country Club Blvd
Cape Coral, FL 33990-3027
Phone (239) 424-1900

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-2606

2776 Cleveland Ave
Fort Myers, FL 33901-5864
Phone (239) 343-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN0000012022TNMDNurse Practitioner
APRN10000898FLMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Health System Inc Nurse Practitioner CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System Nurse Practitioner Current Accepting new patients
Lee Memorial Health System CurrentSince Mar 7, 2022 Accepting new patients
Lee Memorial Health System CurrentSince Mar 7, 2022 Accepting new patients
Florida Neurology Group P L CurrentSince Dec 24, 2018 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

1569 Matthew Dr
Fort Myers, FL 33907
Phone (941) 939-1700

12600 Creekside Ln
Ste 2
Fort Myers, FL 33919
Phone (239) 343-9235

12670 Whitehall Dr
Fort Myers, FL 33907
Phone (239) 936-3554

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: nthompson134358@direct.leememorial.org

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686009600000",
    "number": "1639115355",
    "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": "239-343-9235",
            "fax_number": "239-343-4008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12600 CREEKSIDE LN STE 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193353",
            "telephone_number": "239-343-9235",
            "fax_number": "239-343-4008"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9314 Park West Blvd",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234330",
            "country_code": "US",
            "telephone_number": "865-694-0577",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "NICOLE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000012022",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "APRN10000898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.