Individual provider Active NPI

Jenna Guerin

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1841075033
Registry record updated Oct 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118061 Issued in FL
Practice address
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone
(239) 343-6260
Fax
(239) 343-6259
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2023

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 PA9118061 FL Primary

Addresses

Primary practice location

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Mailing address

4084 Wilmont PL
Fort Myers, FL 33916-8042
Phone (203) 597-7998

Other identifiers 1

IdentifierTypeStateIssuer
119970000MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jguerin346306@Direct.leememorial.org Direct Lee Memorial Health System

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
I20231018000863 FL Practitioner - Physician Assistant 6305291816 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9118061FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Oct 23, 2023 Accepting new patients
Lee Memorial Health System CurrentSince Oct 23, 2023 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients

Locations

1138 Country Club Blvd
Cape Coral, FL 33990
Phone (239) 424-1900

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

9981 S Healthpark Dr
Fort Myers, FL 33908
Phone (239) 332-5344

8931 Colonial Center Dr
Ste 401
Fort Myers, FL 33905
Phone (239) 424-2030

930 S Main St
Ste C
Labelle, FL 33935
Phone (239) 674-5520

Interoperability endpoints

  • Direct secure messaging: jguerin346306@direct.leememorial.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1841075033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4084 WILMONT PL",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339168042",
            "telephone_number": "203-597-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9981 S HEALTHPARK DR",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339083618",
            "telephone_number": "239-343-6260",
            "fax_number": "239-343-6259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUERIN",
        "first_name": "JENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119970000",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jguerin346306@Direct.leememorial.org",
            "affiliation": "Y",
            "affiliationName": "Lee Memorial Health System",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2776 Cleveland Ave",
            "city": "Fort Myers",
            "state": "FL",
            "country_code": "US",
            "postal_code": "339015864",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.