NPIMap

Organization Active NPI

Lee Memorial Home Health Inc

Doing business as Lee Memorial Home Health

  • Home Health Agency
  • Fort Myers, FL
National Provider Identifier
1689672065
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA20643096 Issued in FL
Legal business name
LEE MEMORIAL HOME HEALTH INC
Doing business as
Lee Memorial Home Health
Practice address
12801 Westlinks Dr Ste 101
Fort Myers, FL 33913-8001
Phone
(239) 225-7700
Fax
(239) 343-4103
NPI assigned
Jul 11, 2005
Last updated
May 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Authorized official

Name
Jonathan Hollandar, RN, MBA
Title
System Director/Administrator Home
Phone
(239) 225-7688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA20643096 FL Primary

Addresses

Primary practice location

12801 Westlinks Dr Ste 101
Fort Myers, FL 33913-8001

Mailing address

12771 Westlinks Dr
Suite 9
Fort Myers, FL 33913-8074
Phone (239) 225-7700

Other identifiers 2

IdentifierTypeStateIssuer
1013546OtherFLACM - PROVIDER NUMBER
083918300MedicaidFL

Other names 1

  • Lee Memorial Home Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160922000039 FL Part A Provider - Home Health Agency 1850504069 Practice locations: Fort Myers, FL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1689672065. Details of each certification follow.

Home health agency certification: CCN 107191

Legal name
LEE MEMORIAL HOME HEALTH ,INC.
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Dec 16, 1981
Last certification
Jul 12, 2019
Ownership / control type
Non-Profit
Organization structure
GovernmentNon-profit
Incorporated
Apr 5, 1996 in FL
Enrollment address
12801 Westlinks Dr
Fort Myers, FL 33913-8001

Care Compare: Home health agency

Medicare Care Compare
Listed as
Lee Memorial Home Health, Inc.CCN 107191 · All quality measures
Overall star rating
3.5 of 5
Ownership
Non-Profit
Certified
Dec 16, 1981
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

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
10D1006506Lee Health Home Health12801 Westlinks Drive Suite 102, Fort Myers, FL 33913Certificate of waiverNov 24, 2026

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

12771 Westlinks Dr
Ste 9
Fort Myers, FL 33913

12801 Westlinks Dr
Fort Myers, FL 33913

12801 Westlinks Dr
Ste 101
Fort Myers, FL 33913
Phone (239) 225-7700

Ownership & related parties

All disclosed owners & managing parties 16

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
David Collins Individual Corporate Director Nov 1, 2024
Lawrence R Antonucci Individual Corporate OfficerPresident and Ceo Sep 25, 2020
Corporate Director Nov 1, 2024
Nancy McGovern Individual Corporate DirectorSecretary Nov 1, 2024
Peter Andruszkiewicz Individual Corporate DirectorDirector Jan 16, 2025
Diane Champion Individual Corporate Director Nov 1, 2024
Therese Everly Individual Corporate Director Nov 1, 2024
Joeseph Catti Individual Corporate DirectorDirector Jan 16, 2025
Kathy Bridge-Liles Individual Corporate Director Nov 1, 2024
David H Klein Individual Corporate Director Nov 1, 2024
Dane Allen Individual Corporate DirectorSecretary Nov 1, 2024
Diana Katich Individual W-2 Managing EmployeeDirector Reimbursement Sep 21, 2022
William Gruver Individual Corporate DirectorDirector Jan 16, 2025
Benjamin Spence Individual Corporate OfficerChief Financial Officer Sep 7, 2015
W-2 Managing EmployeeCfo Sep 7, 2015
Stephen Brown Individual Corporate Director Nov 1, 2024
Donna Clarke Individual Corporate Director Nov 1, 2024
Lee Health System Inc Organization, Fort Myers, FL Corporation, Non-profit, Chain home office 5% Or Greater Direct Ownership Interest Nov 1, 2024 100%

Owners & managing parties with NPI records 11

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 6

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

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.

Affiliated clinicians 90

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1689672065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12771 WESTLINKS DR",
            "address_2": "SUITE 9",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138074",
            "telephone_number": "239-225-7700",
            "fax_number": "239-225-7699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12801 WESTLINKS DR STE 101",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138001",
            "telephone_number": "239-225-7700",
            "fax_number": "239-343-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE MEMORIAL HOME HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "HOLLANDAR",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "SYSTEM DIRECTOR/ADMINISTRATOR HOME",
        "authorized_official_telephone_number": "239-225-7688",
        "authorized_official_credential": "RN, MBA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "FL",
            "license": "HHA20643096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACM - PROVIDER NUMBER",
            "identifier": "1013546",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083918300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee Memorial Home Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.