Organization Active NPI

Serendipity Health & Wellness LLC

  • Primary Care Clinic/Center
  • Fort Myers, FL
National Provider Identifier
1700462942
Registry record updated Jan 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
SERENDIPITY HEALTH & WELLNESS LLC
Practice address
3900 Broadway Ste a-14
Fort Myers, FL 33901-8193
Phone
(941) 777-4542
Fax
(239) 579-6807
NPI assigned
Mar 18, 2021
Last updated
Jan 28, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2024

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

Authorized official

Name
Marissa Roberts, APRNNPI 1306201520
Title
Owner/Provider
Phone
(941) 777-4542

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

3900 Broadway Ste a-14
Fort Myers, FL 33901-8193

Mailing address

3900 Broadway Ste B8
Fort Myers, FL 33901-8193
Phone (941) 777-4542

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hello@serendipityhealthandwellness.sprucecare.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210513000142 FL Part B Supplier - Clinic/Group Practice 4486063948 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Myers, FL

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
10D2273524Serendipity Health and Wellness LLC3900 Broadway Suite B8, Fort Myers, FL 33901Certificate of waiverDec 13, 2026

National Provider Directory

National Provider Directory

Locations

3900 Broadway
#A14
Fort Myers, FL 33901

3900 Broadway
Ste A14
Fort Myers, FL 33901
Phone (941) 777-4542

3900 Broadway
Ste B8
Fort Myers, FL 33901
Phone (941) 777-4542

Interoperability endpoints

  • Direct secure messaging: hello@serendipityhealthandwellness.sprucecare.com

Practitioners & affiliated clinicians

Practitioners 3

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": "1616025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706400000000",
    "number": "1700462942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 BROADWAY STE B8",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018193",
            "telephone_number": "941-777-4542",
            "fax_number": "239-579-6807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 BROADWAY STE A-14",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339018193",
            "telephone_number": "941-777-4542",
            "fax_number": "239-579-6807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERENDIPITY HEALTH & WELLNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-18",
        "last_updated": "2024-01-28",
        "certification_date": "2024-01-28",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "MARISSA",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "941-777-4542",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hello@serendipityhealthandwellness.sprucecare.com",
            "affiliation": "N",
            "endpointDescription": "Direct Message/Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3900 Broadway Ste B8",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339018193",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Jan 28, 2024; 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.