JESSICA LYNN ANDERSON-RIDDELL (NPI# 1073768990) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073768990 |
| Entity Type | Individual |
| Full Name | JESSICA LYNN ANDERSON-RIDDELL |
| Other Name | JESSICA LYNN ANDERSON |
| Credential | ARNP |
| Practice Address |
28930 Trails Edge Blvd Suite 200 Bonita Springs FL 34134-7518 |
| Mailing Address |
2234 Colonial Blvd Attn: Payer Contracting & Relations Dept. Fort Myers FL 33907-1412 |
| Practice Telephone | 2392930294 |
| Practice Fax Number | 2399925785 |
| Mailing Telephone | 2399317342 |
| Mailing Fax Number | 2399317385 |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2013-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | ARNP9283140 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
ARNP9283140 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 009559000 | 05 | |
| FL | RAILROAD MCR | P01232801 | 01 |
| Street Address |
28930 TRAILS EDGE BLVD SUITE 200 |
| City | BONITA SPRINGS |
| State | FL |
| Zip Code | 34134-7518 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639650161 | Trails Edge Surgery Center, LLC | Clinic/Center | 28930 Trails Edge Blvd, Bonita Springs, FL 34134-7582 | 2018-08-23 |
| 1306209200 | Gulfshore Urology LLC | Urology | 28930 Trails Edge Blvd, Suite 200, Bonita Springs, FL 34134-7582 | 2016-03-30 |
| 1659711018 | 21st Century Oncology LLC | Durable Medical Equipment & Medical Supplies | 28930 Trails Edge Blvd, Bonita Springs, FL 34134-7582 | 2013-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255803706 | Sheila Mourick | Home Health | 3920 Via Del Ray, Suite 4, Bonita Springs, FL 34134 | 2018-12-21 |
| 1447702162 | Averie Bendana | Hearing Instrument Specialist | 15 8th St Suite B, Hoglund Family Hearing, Bonita Springs, FL 34134 | 2016-10-28 |
| 1366990830 | Jordania Psychiatry LLC | Clinic/Center | 25111 Pennyroyal Dr, Bonita Springs, FL 34134 | 2016-09-14 |
| 1447682497 | Shancy Varghese Kanacheril | Pharmacist | 25121 S. Tamiami Trail, Bonita Springs, FL 34134 | 2013-08-01 |
| 1861762163 | Alyssa Haraczy | Pharmacist | 25121 S. Tamiami Trl, Bonita Springs, FL 34134 | 2012-01-04 |
| 1982905659 | Jessica Ann Rosen | Speech-Language Pathologist | 3384 Woods Edge Cir Ste 104, Bonita Springs, FL 34134 | 2010-11-10 |
| 1902116718 | Keenan Chiropractic Pa | Chiropractor | 3388 Woods Edge Circle Suite 102, Bonita Springs, FL 34134 | 2010-10-14 |
| 1659683076 | Amy Marie Mcneal | Massage Therapist | 28811 S. Tamiami Trail Unit 13-14, Bonita Springs, FL 34134 | 2010-07-14 |
| 1740509157 | Sarah Churton | Dermatology | 23471 Walden Center Drive, Suite 300, Bonita Springs, FL 34134 | 2010-05-25 |
| 1609003516 | Ram Prasad Kafle | Family Medicine | 26800 S Tamiami Trl Ste 340, Bonita Springs, FL 34134 | 2009-06-18 |
| Find all providers in zip 34134 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396735353 | Julianne Marie Stewart | Nurse Practitioner | 9776 Bonita Beach Rd Se Ste 201a, Bonita Springs, FL 34135-4775 | 2005-10-21 |
| 1205138948 | Susan Eileen Hildebrandt | Nurse Practitioner | 26800 S Tamiami Trl Ste 340, Bonita Springs, FL 34134-4355 | 2010-12-01 |
| 1891740171 | Donna Marie Newhard | Nurse Practitioner | 3501 Health Center Blvd, Bonita Springs, FL 34135-8127 | 2006-05-24 |
| 1720066681 | Adela Hunt | Nurse Practitioner | 3501 Health Center Blvd, Suite 2310, Bonita Springs, FL 34135-8127 | 2006-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770340 | Ashley Mae Fleck | Nurse Practitioner | 3428 Sepia St, West Melbourne, FL 32904-7588 | 2020-11-08 |
| 1356942031 | Jorge Luis Ulloa Capestany | Nurse Practitioner | 6865 W 7th Ave Apt 408, Hialeah, FL 33014-4877 | 2020-11-08 |
| 1316548126 | Mitza Lacroix | Nurse Practitioner | 2670 Sw 83rd Ave, Miramar, FL 33025-7413 | 2020-11-06 |
| 1295336337 | Eduardo Wilfredo Loredo | Nurse Practitioner | 2930 Nw 156th St, Opa Locka, FL 33054-2226 | 2020-11-05 |
| 1962003004 | Yudaisy Salgueiro | Nurse Practitioner | 307 Nw 72nd Ave Apt 319, Miami, FL 33126-4304 | 2020-11-05 |
| 1992306146 | Nicole Lyn Burks | Nurse Practitioner | 11916 W Sample Rd, Coral Springs, FL 33065-4200 | 2020-11-04 |
| 1790386811 | Louise Lorraine Voltaire | Nurse Practitioner | 7728 Nw Greenspring St, Port St Lucie, FL 34987-3052 | 2020-11-04 |
| 1750982294 | Hyun-ae Kuh | Nurse Practitioner | 1628 Slash Pine Pl, Oviedo, FL 32765-6270 | 2020-11-02 |
| 1033719687 | Biviana Maria Arroyave | Nurse Practitioner | 2293 Ne 122nd St, North Miami, FL 33181-2910 | 2020-10-30 |
| 1831799790 | Jennmobilemed, Inc. | Nurse Practitioner | 631 Sw 17th Ct, Boca Raton, FL 33486-6413 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | BONITA SPRINGS |
| Zip Code | 34134 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.