Individual provider Active NPI

Jordan Glee Poe, PA-C

  • Physician Assistant
  • San Diego, CA
National Provider Identifier
1104779123
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
35000 Guadalcanal St BLDG 596
San Diego, CA 92140-5599
Phone
(619) 524-1565
Fax
(619) 524-0852
NPI assigned
Feb 18, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

35000 Guadalcanal St BLDG 596
San Diego, CA 92140-5599

Mailing address

35000 Guadalcanal St BLDG 596
San Diego, CA 92140-5599
Phone (619) 524-1565

Other names 1

  • Jordan Glee Wersinger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1771372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771372800000",
    "number": "1104779123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35000 GUADALCANAL ST BLDG 596",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921405599",
            "telephone_number": "619-524-1565",
            "fax_number": "619-524-0852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35000 GUADALCANAL ST BLDG 596",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921405599",
            "telephone_number": "619-524-1565",
            "fax_number": "619-524-0852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "JORDAN",
        "middle_name": "GLEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-18",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "WERSINGER",
            "middle_name": "GLEE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.