Individual provider Active NPI

Jenny Conrado, ARNP

  • Family Nurse Practitioner
  • Fort Myers, FL
National Provider Identifier
1043601453
Registry record updated Jul 10, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
ARNP9282434 Issued in FL
Practice address
13670 Metropolis Ave Ste 106
Fort Myers, FL 33912
Phone
(239) 444-8969
Fax
(239) 466-2035
NPI assigned
Feb 8, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X ARNP9282434 FL Primary

Addresses

Primary practice location

13670 Metropolis Ave Ste 106
Fort Myers, FL 33912

Mailing address

13670 Metropolis Ave Ste 106
Fort Myers, FL 33912-4346
Phone (239) 444-8969

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150506001647 FL Practitioner - Nurse Practitioner 3274852645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
May accept Medicare assignment
Group practices
Jec Physician Services LLCGroup PAC ID 2769754258, 4 clinicians

Practice addresses (Care Compare)

5272 Summerlin Commons Way
Fort Myers, FL 33907-2156
Phone (239) 444-8969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
ARNP9282434FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jec Physician Services, LLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

13670 Metropolis Ave
Ste 106
Fort Myers, FL 33912
Phone (239) 444-8969

5272 Summerlin Commons Way
Ste 603
Fort Myers, FL 33907
Phone (239) 444-8969

5272 Summerlin Commons Way
Fort Myers, FL 33907
Phone (239) 444-8969

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1423353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1043601453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13670 METROPOLIS AVE STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339124346",
            "telephone_number": "239-444-8969",
            "fax_number": "239-466-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13670 METROPOLIS AVE STE 106",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "33912",
            "telephone_number": "239-444-8969",
            "fax_number": "239-466-2035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONRADO",
        "first_name": "JENNY",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-08",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9282434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.