Individual provider Active NPI

Joy Hasseman, PA

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1861820664
Registry record updated Oct 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9107606 Issued in FL
Practice address
12670 Creekside LN
Suite 202
Fort Myers, FL 33919-3370
Phone
(239) 482-2663
Fax
(239) 489-1235
NPI assigned
Oct 15, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2013

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 PA9107606 FL Primary

Addresses

Primary practice location

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

Mailing address

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

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)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1381795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381795200000",
    "number": "1861820664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN",
            "address_2": "SUITE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-489-1235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12670 CREEKSIDE LN",
            "address_2": "SUITE 202",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339193370",
            "telephone_number": "239-482-2663",
            "fax_number": "239-489-1235"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSEMAN",
        "first_name": "JOY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-15",
        "last_updated": "2013-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9107606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2013; 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.