Individual provider Active NPI

Jordan Dana Rosenstein

  • Physician Assistant
  • Columbia, TN
National Provider Identifier
1013419498
Registry record updated Jan 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1224 Trotwood Ave
Columbia, TN 38401
Phone
(931) 381-1111
NPI assigned
Mar 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary
Physician Assistant 363A00000X 5301 TN

Addresses

Primary practice location

1224 Trotwood Ave
Columbia, TN 38401

Mailing address

2615 Chester Ave
Bakersfield, CA 93301-2014
Phone (661) 869-6200

Other practice location 1

2615 Chester Ave
Bakersfield, CA 93301-2014
Phone (661) 395-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180521002028 CA Practitioner - Physician Assistant 7719242866 Reassigns benefits to 2 organizations
I20230307002747 TN Practitioner - Physician Assistant 7719242866 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55512CAMDCritical Care Pharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince May 1, 2018 Accepting new patients
Priority Urgent Care CurrentSince Apr 8, 2019 Accepting new patients
Priority Urgent Care CurrentSince Apr 8, 2019 Accepting new patients

Locations

4821 Panama Ln
Ste Ac
Bakersfield, CA 93313
Phone (661) 556-4777

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1519862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1013419498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 CHESTER AVE",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012014",
            "telephone_number": "661-869-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1224 TROTWOOD AVE",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "38401",
            "telephone_number": "931-381-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 Chester Ave",
            "address_purpose": "LOCATION",
            "city": "Bakersfield",
            "state": "CA",
            "postal_code": "933012014",
            "country_code": "US",
            "telephone_number": "661-395-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROSENSTEIN",
        "first_name": "JORDAN",
        "middle_name": "DANA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-01",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5301",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, TN

Sources for this page

Verify at the official NPI Registry.