Individual provider Active NPI

Jeordan Rae Delp, PA-C

  • Physician Assistant
  • Fort Myers, FL
National Provider Identifier
1952143703
Registry record updated Aug 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118884 Issued in FL
Practice address
9981 S Healthpark Dr
Fort Myers, FL 33908-3618
Phone
(239) 343-2606
Fax
(239) 343-3695
NPI assigned
Jun 12, 2024
Last updated
Aug 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 7, 2024

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 PA9118884 FL Primary

Addresses

Primary practice location

9981 S Healthpark Dr
Fort Myers, FL 33908-3618

Mailing address

PO Box 2147
Fort Myers, FL 33902-2147
Phone (239) 343-2606

Other practice location 1

13681 Doctors Way
Fort Myers, FL 33912-4300
Phone (239) 343-1000

Other identifiers 1

IdentifierTypeStateIssuer
122851200MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jdelp406032@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
I20240709002265 FL Practitioner - Physician Assistant 0547705055 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lee Memorial Health System CurrentSince Aug 1, 2024 Accepting new patients
Lee Health System Inc CurrentSince Nov 1, 2024 Accepting new patients
Lee Memorial Health System CurrentSince Aug 1, 2024 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

13681 Doctors Way
Fort Myers, FL 33912
Phone (239) 343-1000

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

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

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

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

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: jdelp406032@direct.leememorial.org

Organizations & group practices 5

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": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1952143703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2147",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339022147",
            "telephone_number": "239-343-2606",
            "fax_number": "239-343-3695"
        },
        {
            "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": "239-343-2606",
            "fax_number": "239-343-3695"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13681 Doctors Way",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339124300",
            "country_code": "US",
            "telephone_number": "239-343-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DELP",
        "first_name": "JEORDAN",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-12",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118884",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "122851200",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jdelp406032@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.