Individual provider Active NPI

Adam Lee Heller, MD

  • Neurology Physician
  • Fort Myers, FL
National Provider Identifier
1710183041
Registry record updated Jan 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
ME100599 Issued in FL
Practice address
11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone
(239) 208-2212
Fax
(239) 208-3994
NPI assigned
Jun 24, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2023

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 28703 NE
Neurology Physician 2084N0400X 057372 GA
Neurology Physician 2084N0400X TM00626 TX
Neurology Physician 2084N0400X 35.125483 OH
Neurology Physician 2084N0400X 4301108303 MI
Neurology Physician 2084N0400X 51221 AZ
Neurology Physician 2084N0400X 24286 MS
Neurology Physician 2084N0400X 17306 NH
Neurology Physician 2084N0400X 13996 ND
Neurology Physician 2084N0400X MD171346 OR
Neurology Physician 2084N0400X ME100599 FL Primary

Addresses

Primary practice location

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206

Mailing address

11215 Metro Pkwy Ste 1
Fort Myers, FL 33966-1206
Phone (239) 208-2212

Other identifiers 2

IdentifierTypeStateIssuer
3112981MedicaidNH
000313300MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080728000422 FL Practitioner - Neurology 5991879793 Reassigns benefits to 1 organization
I20151223001731 OR Practitioner - Neurology 5991879793 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
51221AZMDNeurology Physician
ME100599FLMDNeurology Physician
057372GAMDNeurology Physician
24286MSMDNeurology Physician
28703NEMDNeurology Physician
17306NHMDNeurology Physician
MD171346ORMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtual Neurology, LLC Neurology CurrentSince Jun 11, 2013 Accepting new patients
Legacy Clinics LLC Family Medicine CurrentSince Nov 7, 2015 Accepting new patients
Piedmont Athens Specialty Care LLC Past Accepting new patients
Clinic Pharmacy Inc Past Accepting new patients
Lima Memorial Joint Operating Company Past Accepting new patients

Locations

11215 Metro Pkwy
Ste 100
Fort Myers, FL 33966
Phone (239) 208-2206

9110 College Pointe Ct
Fort Myers, FL 33919
Phone (239) 208-2206

11215 Metro Pkwy
Ste 1
Fort Myers, FL 33966
Phone (239) 208-2206

24800 SE Stark St
Gresham, OR 97030
Phone (503) 413-8407

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

Interoperability endpoints

  • Direct secure messaging: aheller32897@lakeland.midirect.net

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1182643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1710183041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212",
            "fax_number": "239-208-3994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 METRO PKWY STE 1",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339661206",
            "telephone_number": "239-208-2212",
            "fax_number": "239-208-3994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELLER",
        "first_name": "ADAM",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-24",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NE",
            "license": "28703",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "GA",
            "license": "057372",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "TM00626",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "35.125483",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MI",
            "license": "4301108303",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "AZ",
            "license": "51221",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "24286",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NH",
            "license": "17306",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "ND",
            "license": "13996",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OR",
            "license": "MD171346",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME100599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3112981",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000313300",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.