Jordan Nicole McCowen, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2018029942 Issued in MO

Practice address

2 Harbor Bend CT Ste 102
Lake Saint Louis, MO 63367-1480

Phone

(636) 295-2070

NPI assigned

Feb 26, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Jordan Nicole Porter Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1551139200000",
    "number": "1003373085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 HARBOR BEND CT STE 102",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HARBOR BEND CT STE 102",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671480",
            "telephone_number": "636-295-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOWEN",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-26",
        "last_updated": "2019-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2018029942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "PORTER",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Physical Therapist in Lake Saint Louis, MO
• Providers in Lake Saint Louis, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2019; 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.