Individual provider Active NPI

Amanda Lang Dennis, ARNP

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1659866408
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9261099 Issued in FL
Practice address
1555 Coconut Dr
Fort Myers, FL 33901-6805
Phone
(239) 851-0758
NPI assigned
Jun 25, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9261099 FL Primary

Addresses

Primary practice location

1555 Coconut Dr
Fort Myers, FL 33901-6805

Mailing address

1555 Coconut Dr
Fort Myers, FL 33901-6805
Phone (239) 851-0758

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adennis116634@Direct.leememorial.org Direct Lee Memorial Health System

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
I20220110001240 FL Practitioner - Nurse Practitioner 7315339058 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
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

1682 NE Pine Island Rd
Cape Coral, FL 33909-1756
Phone (239) 424-1600

3501 Health Ctr Blvd
Estero, FL 34135-8127

4751 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9888

4771 S Cleveland Ave
Fort Myers, FL 33907-1317
Phone (239) 343-9800

507 Cape Coral Pkwy E
Cape Coral, FL 33904-8545
Phone (239) 549-8789

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9261099FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Jan 6, 2022 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Jan 6, 2022 Accepting new patients
Lee Health System Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

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

1682 NE Pine Island Rd
Cape Coral, FL 33909
Phone (239) 424-1600

3501 Health Center Blvd
Ste 1050
Estero, FL 34135
Phone (239) 468-0260

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

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

4771 S Cleveland Ave
Fort Myers, FL 33907
Phone (239) 343-9800

13340 Metro Pkwy
Ste 100
Fort Myers, FL 33966
Phone (239) 343-0490

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

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: adennis116634@direct.leememorial.org

Organizations & group practices 4

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": "1529884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1659866408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 COCONUT DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339016805",
            "telephone_number": "239-851-0758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 COCONUT DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339016805",
            "telephone_number": "239-851-0758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENNIS",
        "first_name": "AMANDA",
        "middle_name": "LANG",
        "name_prefix": "Dr.",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-25",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9261099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adennis116634@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.