NPIMap

Individual provider Active NPI

Jessica Lynn Anderson-Riddell, ARNP

  • Nurse Practitioner
  • Bonita Springs, FL
National Provider Identifier
1073768990
Registry record updated Dec 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
ARNP9283140 Issued in FL
Practice address
28930 Trails Edge Blvd
Suite 200
Bonita Springs, FL 34134-7518
Phone
(239) 293-0294
Fax
(239) 992-5785
NPI assigned
Nov 19, 2008
Last updated
Dec 20, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X ARNP9283140 FL Primary
Family Nurse Practitioner 363LF0000X ARNP9283140 FL

Addresses

Primary practice location

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
Phone (239) 931-7342

Other identifiers 2

IdentifierTypeStateIssuer
009559000MedicaidFL
P01232801OtherFLRAILROAD MCR

Other names 1

  • Jessica Lynn Anderson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170626001741 NC Practitioner - Nurse Practitioner 3870650260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

3480 Wake Forest Rd
Raleigh, NC 27609-7376
Phone (919) 684-8111

40 Duke Medicine Cir
Durham, NC 27710-4000
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ARNP9283140FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients

Locations

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

3480 Wake Forest Rd
Raleigh, NC 27609
Phone (919) 684-4267

Interoperability endpoints

  • Direct secure messaging: jandersonriddell293650@direct.medicine.duke.edu

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1227052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387497600000",
    "number": "1073768990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2234 COLONIAL BLVD",
            "address_2": "ATTN: PAYER CONTRACTING & RELATIONS DEPT.",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339071412",
            "telephone_number": "239-931-7342",
            "fax_number": "239-931-7385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28930 TRAILS EDGE BLVD",
            "address_2": "SUITE 200",
            "city": "BONITA SPRINGS",
            "state": "FL",
            "postal_code": "341347518",
            "telephone_number": "239-293-0294",
            "fax_number": "239-992-5785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON-RIDDELL",
        "first_name": "JESSICA",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-19",
        "last_updated": "2013-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP9283140",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "ARNP9283140",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009559000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P01232801",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "ANDERSON",
            "middle_name": "LYNN",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bonita Springs, FL

Sources for this page

Verify at the official NPI Registry.