Individual provider Active NPI

Eric P Eck, DO

  • General Practice Physician
  • Fort Myers, FL
National Provider Identifier
1790348233
Registry record updated Feb 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
OS17406 Issued in FL
Practice address
10676 Colonial Blvd Ste 30
Fort Myers, FL 33913-8715
Phone
(413) 438-7848
Fax
(239) 256-5307
NPI assigned
Apr 19, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X OS17406 FL Primary

Addresses

Primary practice location

10676 Colonial Blvd Ste 30
Fort Myers, FL 33913-8715

Mailing address

10676 Colonial Blvd Ste 30
Fort Myers, FL 33913-8715
Phone (413) 438-7848

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS17406FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Drquit LLC General Practice CurrentSince Sep 28, 2021 Accepting new patients

Locations

10676 Colonial Blvd
Ste 30
Fort Myers, FL 33913
Phone (413) 438-7848

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22489/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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": "1555632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1790348233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10676 COLONIAL BLVD STE 30",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138715",
            "telephone_number": "413-438-7848",
            "fax_number": "239-256-5307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10676 COLONIAL BLVD STE 30",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138715",
            "telephone_number": "413-438-7848",
            "fax_number": "239-256-5307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ECK",
        "first_name": "ERIC",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-19",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "OS17406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.