Individual provider Active NPI

Jennifer Ann Jordan, M.D.

  • Otolaryngology Physician
  • Dallas, TX
National Provider Identifier
1003808528
Registry record updated Feb 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
J9721 Issued in TX
Practice address
1130 Beachview St
Suite 240
Dallas, TX 75218-3700
Phone
(214) 324-0418
Fax
(214) 324-0693
NPI assigned
Aug 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2014

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X J9721 TX
Pediatric Otolaryngology Physician 207YP0228X J9721 TX
Sleep Medicine (Otolaryngology) Physician 207YS0012X J9721 TX
Otolaryngology Physician 207Y00000X J9721 TX Primary
Surgical Oncology Physician 2086X0206X J9721 TX

Addresses

Primary practice location

1130 Beachview St
Suite 240
Dallas, TX 75218-3700

Mailing address

1130 Beachview St
Suite 240
Dallas, TX 75218-3700
Phone (214) 324-0418

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111212000855 TX Practitioner - Otolaryngology 4284677048 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Indiana University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The ENT and Allergy Centers of Texas, PLLCGroup PAC ID 4385709054, 56 clinicians

Practice addresses (Care Compare)

1130 Beachview St
Suite 240
Dallas, TX 75218-3703
Phone (214) 324-0418

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The ENT & Allergy Centers of Texas, PLLC Otolaryngology CurrentSince Jan 1, 2023 Accepting new patients
Richard D Thrasher III MD PA Otolaryngology Past Accepting new patients

Locations

1130 Beachview St
Ste 240
Dallas, TX 75218
Phone (214) 324-0418

5220 W University Dr
Ste 150
McKinney, TX 75071
Phone (972) 632-3270

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393372800000",
    "number": "1003808528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 BEACHVIEW ST",
            "address_2": "SUITE 240",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183700",
            "telephone_number": "214-324-0418",
            "fax_number": "214-324-0693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1130 BEACHVIEW ST",
            "address_2": "SUITE 240",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183700",
            "telephone_number": "214-324-0418",
            "fax_number": "214-324-0693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-19",
        "last_updated": "2014-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "J9721",
            "primary": false
        },
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TX",
            "license": "J9721",
            "primary": false
        },
        {
            "code": "207YS0012X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Sleep Medicine",
            "state": "TX",
            "license": "J9721",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "J9721",
            "primary": true
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "J9721",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.