NPIMap

Organization Active NPI

Lee Memorial Health System

Doing business as LCH- Peds Behavioral Health GN BCH

  • Federally Qualified Health Center (FQHC)
  • Estero, FL
National Provider Identifier
1851028823
Registry record updated Dec 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
LEE MEMORIAL HEALTH SYSTEM
Doing business as
LCH- Peds Behavioral Health GN BCH
Practice address
3501 Health Center Blvd Ste 2190
Estero, FL 34135-8133
Phone
(239) 343-6050
Fax
(239) 343-6051
NPI assigned
Aug 1, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2022

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

Authorized official

Name
Joseph Niebergall
Title
Credentialing Specialist
Phone
(239) 424-1446

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

3501 Health Center Blvd Ste 2190
Estero, FL 34135-8133

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-6050

Other names 1

  • LCH- Peds Behavioral Health GN BCH Doing business as

National Provider Directory

National Provider Directory

Member of 1

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

NPI Registry JSON

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

{
    "created_epoch": "1659312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669852800000",
    "number": "1851028823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HEALTH CENTER BLVD STE 2190",
            "city": "ESTERO",
            "state": "FL",
            "postal_code": "341358133",
            "telephone_number": "239-343-6050",
            "fax_number": "239-343-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-01",
        "last_updated": "2022-12-01",
        "certification_date": "2022-12-01",
        "status": "A",
        "authorized_official_last_name": "NIEBERGALL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "239-424-1446"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LCH- Peds Behavioral Health GN BCH",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "LCH- Peds Behavioral Health GN BCH",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Estero, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.