Individual provider Active NPI

Jordanne Brooke Fletcher, PA-C

  • Physician Assistant
  • Petersburg, VA
National Provider Identifier
1194675637
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
200 Medical Park Blvd
Petersburg, VA 23805-9274
Phone
(804) 765-5000
NPI assigned
Feb 3, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 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 VA Primary

Addresses

Primary practice location

200 Medical Park Blvd
Petersburg, VA 23805-9274

Mailing address

200 Medical Park Blvd
Petersburg, VA 23805-9274
Phone (804) 765-5000

Medicare participation

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

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2026
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4535 Dressier Rd NW
Canton, OH 44718-2545

4535 Dressler Rd NW
Canton, OH 44718-2545

909 E Main St
Richmond, VA 23219-3002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1770076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1194675637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MEDICAL PARK BLVD",
            "city": "PETERSBURG",
            "state": "VA",
            "postal_code": "238059274",
            "telephone_number": "804-765-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "JORDANNE",
        "middle_name": "BROOKE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-03",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petersburg, VA

Sources for this page

Verify at the official NPI Registry.