JACOB BUTLER NELSON (NPI# 1487938833) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487938833 |
| Entity Type | Individual |
| Full Name | JACOB BUTLER NELSON |
| Credential | PA-C |
| Practice Address |
7331 College Pkwy Ste 300 Fort Myers FL 33907-5524 |
| Practice Telephone | 2393372003 |
| Practice Fax Number | 2393373168 |
| Mailing Telephone | 2393372003 |
| Mailing Fax Number | 2393373168 |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2019-10-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA9109474 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | MEDICARE | IQ047Z | 01 |
| TN | RR MEDICARE | P01597414 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275037632 | Jacob Dillon Nelson | Student in an Organized Health Care Education/Training Program | 101 Manning Drive W2107 Old Clinic, Chapel Hill, NC 27599-4607 | 2018-03-21 |
| 1396186151 | Jacob C Nelson | Pharmacist | 441 Arrowhead Ln, Moose Lake, MN 55767-7702 | 2013-07-09 |
| 1366756009 | Jacob Isreal Nelson | Behavioral Analyst | 6627 Belle Shadow Ln, Tampa, FL 33634-4263 | 2010-08-05 |
| 1568920882 | Jacob Henry Nelson | Student in an Organized Health Care Education/Training Program | 200 Mullins Dr, Lebanon, OR 97355-3983 | 2019-03-05 |
| 1154800753 | Jacob Nelson | Community Health Worker | 4989 N 3rd St, Laramie, WY 82072-9548 | 2018-08-14 |
| 1598266801 | Jacob I Nelson | Obstetrics & Gynecology | 5131 Beacon Hill Rd Ste 340, Columbus, OH 43228-4442 | 2018-02-22 |
| 1154842136 | Jacob E Nelson | Physical Therapist | 6699 W Rio Grande Ave, Kennewick, WA 99336-3301 | 2017-06-29 |
| 1144675679 | Jacob Nelson | Pediatrics | 697 Louisiana Rd, Dyess Afb, TX 79607-1141 | 2016-05-03 |
| 1831517960 | Jacob Nelson | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2014-04-05 |
| 1104267780 | Jacob H Nelson | Podiatrist | 1520 S Dobson Rd, Suite 307, Mesa, AZ 85202-4725 | 2013-07-11 |
| Street Address |
7331 COLLEGE PKWY STE 300 |
| City | FORT MYERS |
| State | FL |
| Zip Code | 33907-5524 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487633392 | April M Fetzer | Physical Medicine & Rehabilitation | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2006-01-10 |
| 1851906374 | Kassandra Torres | Physician Assistant | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2020-09-11 |
| 1326671553 | Kelly Elizabeth Carney | Physician Assistant | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2020-02-17 |
| 1295205771 | Margaret Jane Zimmerman | Physician Assistant | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2018-11-28 |
| 1073029963 | Lauren Terry | Physical Therapist | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2017-12-14 |
| 1023446689 | Anastasia D Monzone | Physician Assistant | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2013-10-17 |
| 1215163795 | Benjamin Jared Ditty | Neurological Surgery | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2009-06-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134739253 | Islande Dorcin | Social Worker | 13300 South Cleveland Ave Suite 56 # 822, Fort Myers, FL 33907 | 2020-08-04 |
| 1003462268 | Ronny Rodolfo Herrera | Behavior Technician | Beacon Executive Suites, 8359 Beacon Blvd, Suite#416, Homestead, FL 33907 | 2019-08-14 |
| 1528549094 | Deborah Senese Streater | Dentist | 12530 New Brittany Blvd., Fort Myers, FL 33907 | 2018-08-23 |
| 1437648391 | Rita Lusinete Rabitt | Registered Nurse | 14084 Clear Water Ln, Fort Myers, FL 33907 | 2018-05-07 |
| 1972092146 | Surgery Centre of Sw Florida LLC | Clinic/Center | 13051 University Dr Ste 102, Fort Myers, FL 33907 | 2018-05-03 |
| 1740787761 | Care Transport Inc | Non-emergency Medical Transport (VAN) | 7850 Reflection Cove Dr, Fort Myers, FL 33907 | 2018-04-06 |
| 1942730692 | Concierge Care of Fort Myers, LLC | In Home Supportive Care | 12253 New Brittany Boulevard, Suite 32, Fort Myers, FL 33907 | 2017-06-15 |
| 1710411467 | Johnnie Terrell | Social Worker | 43 Barkley Cir #102, Fort Myers, FL 33907 | 2017-04-19 |
| 1881041184 | Hchs Medical Center | Clinic/Center | 35 Barkley Circle, Unit 2, Fort Myers, FL 33907 | 2016-05-17 |
| 1043665227 | Tong Liu | Dentist | 8016 Summerlin Lakes Dr, Fort Myers, FL 33907 | 2016-04-26 |
| Find all providers in zip 33907 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043784432 | Alex Richard Reynolds | Physician Assistant | 2700 Creekside Ln, Suit 101, Fort Myers, FL 33913 | 2019-01-18 |
| 1013261197 | Jamison Dicus | Physician Assistant | 7370 College Pkwy Ste 206, Fort Myers, FL 33907-5558 | 2012-10-29 |
| 1902102445 | Alisa K Romero | Physician Assistant | 12700 Creekside Lane, Suite 101, Fort Myers, FL 33919-3356 | 2011-02-01 |
| 1851691653 | Leslie F Naoom | Physician Assistant | 2531 Cleveland Ave 1, Fort Myers, FL 33901-4900 | 2010-10-26 |
| 1942327366 | Caroline N. Saleeby | Physician Assistant | 2531 Cleveland Ave Ste 1, Fort Myers, FL 33901-4900 | 2007-03-22 |
| 1295815298 | Christina Marie Brushaber | Physician Assistant | 5216 Clayton Ct, Fort Myers, FL 33907-2116 | 2006-10-16 |
| 1952337636 | Joseph Deily Iv | Physician Assistant | 9981 S Healthpark Dr Ste 120, Fort Myers, FL 33908 | 2006-06-24 |
| 1689640732 | Ann V Brock | Physician Assistant | 13340 Metro Pkwy Ste 400, Fort Myers, FL 33966-4818 | 2006-02-28 |
| 1326671553 | Kelly Elizabeth Carney | Physician Assistant | 7331 College Pkwy Ste 300, Fort Myers, FL 33907-5524 | 2020-02-17 |
| 1114440534 | Aleisha Nicole Rees | Physician Assistant | 6821 Palisades Park Ct Ste 1, Fort Myers, FL 33912-7131 | 2017-07-18 |
| Find all providers in FORT MYERS | ||||
| City | FORT MYERS |
| Zip Code | 33907 |
Please comment or provide details below to improve the information on JACOB BUTLER NELSON.
| 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.