NPIMap

Organization Active NPI

Lee Memorial Health System

Doing business as Lee Health Solutions

  • General Practice Physician
  • Cape Coral, FL
National Provider Identifier
1902379209
Registry record updated Jun 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
LEE MEMORIAL HEALTH SYSTEM
Doing business as
Lee Health Solutions
Practice address
501 Del Prado Blvd S
Cape Coral, FL 33990-2618
Phone
(239) 424-3120
Fax
(239) 343-4145
NPI assigned
Jan 9, 2019
Last updated
Jun 14, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2023

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
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

501 Del Prado Blvd S
Cape Coral, FL 33990-2618

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 424-3120

Other practice location 1

12550 New Brittany Blvd
Fort Myers, FL 33907-3655
Phone (239) 424-3120

Other names 1

  • Lee Health Solutions Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190823000462 FL MDPP Supplier - in-Person MDPP Supplier 8729996608 Practice locations: Estero, FL; Fort Myers, FL; Cape Coral, FL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Lee Physician Group OB13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

12550 New Brittany Blvd
Fort Myers, FL 33907
Phone (239) 343-9180

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Rehabilitation Hospital of Fort MyersFort Myers, FL, CCN 103069 Hospital 5% Or Greater Indirect Ownership Interest (49%) Feb 27, 2023

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 4

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": "1546992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686700800000",
    "number": "1902379209",
    "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": "239-424-3120",
            "fax_number": "239-343-4145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DEL PRADO BLVD S",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339902618",
            "telephone_number": "239-424-3120",
            "fax_number": "239-343-4145"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12550 New Brittany Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339073655",
            "country_code": "US",
            "telephone_number": "239-424-3120",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LEE MEMORIAL HEALTH SYSTEM",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-09",
        "last_updated": "2023-06-14",
        "certification_date": "2023-06-14",
        "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": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lee Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lee Health Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.