Organization Active NPI

Blue Sky Medical LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • North Fort Myers, FL
National Provider Identifier
1649055542
Registry record updated Aug 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
BLUE SKY MEDICAL LLC
Practice address
3440 Marinatown LN Ste 210
North Fort Myers, FL 33903-7049
Phone
(239) 230-2000
Fax
(239) 235-4640
NPI assigned
Aug 29, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2025

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

Authorized official

Name
Editha Anne Butler, APRN
Title
Clinical Director
Phone
(803) 260-2223

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

3440 Marinatown LN Ste 210
North Fort Myers, FL 33903-7049

Mailing address

3440 Marinatown LN Ste 210
North Fort Myers, FL 33903-7049
Phone (239) 230-2000

Other names 1

  • Blue Sky Health and Wellness LLC Former legal business name

National Provider Directory

National Provider Directory

Locations

2256 First St
Ste 175
Fort Myers, FL 33901

3444 Marinatown Ln
Ste 2
North Fort Myers, FL 33903
Phone (239) 230-2000

3440 Marinatown Ln
Ste 210
North Fort Myers, FL 33903
Phone (239) 230-2000

NPI Registry JSON

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

{
    "created_epoch": "1693267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756598400000",
    "number": "1649055542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3440 MARINATOWN LN STE 210",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339037049",
            "telephone_number": "239-230-2000",
            "fax_number": "239-235-4640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 MARINATOWN LN STE 210",
            "city": "NORTH FORT MYERS",
            "state": "FL",
            "postal_code": "339037049",
            "telephone_number": "239-230-2000",
            "fax_number": "239-235-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE SKY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-29",
        "last_updated": "2025-08-31",
        "certification_date": "2025-08-31",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "EDITHA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "803-260-2223",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blue Sky Health and Wellness LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Blue Sky Health and Wellness LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in North Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2025; 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.