JORDAN BEAVERSON (NPI# 1578933693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578933693 |
| Entity Type | Individual |
| Full Name | JORDAN BEAVERSON |
| Credential | PA-C |
| Practice Address |
625 9th St N Suite 201 Naples FL 34102-8143 |
| Mailing Address |
27853 Luke St Bonita Springs FL 34134-4066 |
| Practice Telephone | 2392612000 |
| Practice Fax Number | 2392612266 |
| Mailing Telephone | 2398725739 |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA9109103 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
625 9TH ST N SUITE 201 |
| City | NAPLES |
| State | FL |
| Zip Code | 34102-8143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144221854 | Robert G Baily | Internal Medicine | 625 9th St N, Suite 201, Naples, FL 34102-8143 | 2005-08-03 |
| 1629323407 | Jennifer J Mazorra | Nurse Practitioner | 625 9th St N, Suite 201, Naples, FL 34102-8143 | 2012-07-18 |
| 1124268545 | Peter Ray Foster | Internal Medicine | 625 9th St N, Suite 201, Naples, FL 34102-8143 | 2009-02-25 |
| 1851589162 | Sajan Kuchipudi Rao | Specialist | 625 9th St N, Suite 201, Naples, FL 34102-8143 | 2007-10-11 |
| 1881620540 | James V Talano | Internal Medicine | 625 9th St N, Suite 201, Naples, FL 34102-8143 | 2006-06-24 |
| 1831130814 | Scott L Wiesen | Internal Medicine | 625 9th St N, Suite 304, Naples, FL 34102-8143 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710482948 | Aktive Motion Physical Therapy Inc | Clinic/Center | 1250 9th St N Ste 204, Naples, FL 34102 | 2018-03-28 |
| 1912428632 | Daily Care At Home, LLC | Home Health | 180 9th Street South, Suite 200, Naples, FL 34102 | 2017-07-03 |
| 1760737365 | Family Private Care Inc | Home Health | 1008 Goodlette Frank Rd N, Ste 201, Naples, FL 34102 | 2012-07-19 |
| 1013205384 | Valerie Jean Bress | Nurse Practitioner | 350 7th Street, Naples Community Hospital, Naples, FL 34102 | 2011-07-20 |
| 1154573830 | Gustavo D Rivera | Internal Medicine | 1064 Goodlette Road, Naples, FL 34102 | 2008-10-14 |
| 1881872281 | Proscan Imaging Naples, LLC | Radiology | 260 Tamiami Trail N, Naples, FL 34102 | 2008-02-07 |
| 1053595017 | Marlene Ann Diaczynsky | Registered Nurse | 350 7th Street North, Naples Community Hospital, Naples, FL 34102 | 2007-12-26 |
| 1699958330 | Georgiena Cobb | Counselor | 501 Goodlette Rd, Naples, FL 34102 | 2007-12-17 |
| 1124210158 | Maranatha Home Care, Inc. | Registered Nurse | 1164 Goodlette Road, Naples, FL 34102 | 2007-08-14 |
| 1669678645 | Naples Family Dentistry Inc | Dentist | 2176 Tamiami Trail North, Naples, FL 34102 | 2007-06-26 |
| Find all providers in zip 34102 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619575479 | Cristina Marie Lago | Physician Assistant | 2325 Stanford Ct, Naples, FL 34112-4813 | 2020-10-14 |
| 1497375075 | Daniela Herrera Ceballos | Physician Assistant | 7943 Haven Dr Unit 1, Naples, FL 34104-5979 | 2020-04-23 |
| 1215587340 | Aida Brax | Physician Assistant | 13005 Collier Blvd, Naples, FL 34116-4003 | 2019-09-20 |
| 1568931335 | Jonathan Fletcher Michaelis | Physician Assistant | 13020 Livingston Rd Ste 14, Naples, FL 34105-5023 | 2018-11-21 |
| 1669971412 | Chelsea Allan | Physician Assistant | 848 1st Ave N Ste 100, Naples, FL 34102-6063 | 2018-02-07 |
| 1336659622 | Miriam Albritton | Physician Assistant | 1201 Piper Blvd Ste 24, Naples, FL 34110-1385 | 2017-10-02 |
| 1821455262 | Laura Khawaja | Physician Assistant | 7069 Lone Oak Blvd, Naples, FL 34109-8875 | 2016-01-15 |
| 1225429889 | Maria Francesca Zampogna Wilson | Physician Assistant | 6400 Davis Blvd Ste 203, Naples, FL 34104-5321 | 2015-02-17 |
| 1972906113 | Kellie Jo Dunlap | Physician Assistant | 830 105th Ave N, Naples, FL 34108-1844 | 2014-10-02 |
| 1902208077 | Bogdan-gabriel Cozmuta | Physician Assistant | 400 8th Street North, Naples, FL 34102-7906 | 2014-09-20 |
| Find all providers in NAPLES | ||||
Please comment or provide details below to improve the information on JORDAN BEAVERSON.
| 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.