Individual provider Active NPI

Jordana Butler, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1659986677
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118672 Issued in FL
Practice address
12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370
Phone
(239) 482-2663
Fax
(239) 482-7585
NPI assigned
Sep 15, 2020
Last updated
Aug 28, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU
Physician Assistant 363A00000X 5266 WI
Physician Assistant 363A00000X PA9118672 FL Primary

Addresses

Primary practice location

12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370

Mailing address

12670 Creekside LN Ste 202
Fort Myers, FL 33919-3370
Phone (239) 482-2663

Other practice location 1

8831 Founders Square Dr Fl 1
Naples, FL 34120-0733
Phone (239) 482-2663

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
I20240612004431 FL Practitioner - Physician Assistant 3971914953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Orthopedic Center of Florida, IncGroup PAC ID 9931183639, 48 clinicians

Practice addresses (Care Compare)

10201 Arcos Ave
Suite 206
Estero, FL 33928-9461
Phone (239) 946-4880

12670 Creekside LN
Fort Myers, FL 33919-3370
Phone (239) 482-2663

3530 Kraft Rd
Suite 201
Naples, FL 34105-5020
Phone (239) 482-2663

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5266WIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Center of Florida, Inc CurrentSince Jun 1, 2024 Accepting new patients
Orthopedic Center of Florida, Inc PastSince Jan 8, 2023 Accepting new patients

Locations

12670 Creekside Ln
Ste 202
Fort Myers, FL 33919
Phone (239) 267-2263

3530 Kraft Rd
Ste 201
Naples, FL 34105
Phone (239) 445-2112

8831 Founders Square Dr
Fl 1
Naples, FL 34120
Phone (239) 482-2663

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6140/brand/1/csg/1/fhir/r4
  • Direct secure messaging: jordana.butler.1@22724.direct.athenahealth.com

Organizations & group practices 2

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 5

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": "1600128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1659986677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN STE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8831 Founders Square Dr Fl 1",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341200733",
            "country_code": "US",
            "telephone_number": "239-482-2663",
            "fax_number": "239-482-7585",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUTLER",
        "first_name": "JORDANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-15",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "5266",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.