NPIMap

Individual provider Active NPI

George Lee Jordan III, DO

  • Diagnostic Radiology Physician
  • Greenville, NC
National Provider Identifier
1023197126
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
200200929 Issued in NC
Practice address
2101 W Arlington Blvd Ste 210
Greenville, NC 27834-5758
Phone
(252) 752-5000
Fax
(252) 931-7694
NPI assigned
Nov 2, 2006
Last updated
Sep 2, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Physician 207U00000X 200200929 NC
Diagnostic Radiology Physician 2085R0202X 200200929 NC Primary

Addresses

Primary practice location

2101 W Arlington Blvd Ste 210
Greenville, NC 27834-5758

Mailing address

PO Box 30750
Greenville, NC 27833-0750
Phone (252) 752-5000

Other identifiers 2

IdentifierTypeStateIssuer
89132A8MedicaidNC
132A8OtherNCBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031119000893 NC Practitioner - Diagnostic Radiology 5496659708 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio University, College of Osteopathic Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Radiologists IncGroup PAC ID 2466355383, 92 clinicians

Practice addresses (Care Compare)

2101 W Arlington Blvd
Suite 210
Greenville, NC 27834-5758
Phone (252) 752-5000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200200929NCMDNuclear Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Radiologists Inc Diagnostic Radiology CurrentSince Oct 1, 2011 Accepting new patients
Sentara Advanced Imaging Solutions, LLC Diagnostic Radiology CurrentSince Jan 1, 2024 Accepting new patients
Peninsula Radiological Associates Limited Diagnostic Radiology PastSince Aug 28, 2021 Accepting new patients
Sentara Albemarle Regional Medical Center Past Accepting new patients
Eastern Radiologists, Inc Diagnostic Radiology Past Accepting new patients
Coastal Carolina Radiology, PLLC Diagnostic Radiology PastSince Jan 1, 2008 Accepting new patients
Danville Radiologists Inc Diagnostic Radiology Past Accepting new patients

Locations

1144 N Road St
Elizabeth Cty, NC 27909
Phone (252) 384-4610

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

2101 W Arlington Blvd
#210
Greenville, NC 27834

2101 W Arlington Blvd
Ste 210
Greenville, NC 27834
Phone (252) 931-7638

5200 N Croatan Hwy
Kitty Hawk, NC 27949
Phone (252) 261-4187

630 E 11th St
Washington, NC 27889
Phone (252) 946-2137

Organizations & group practices 7

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1023197126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 30750",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278330750",
            "telephone_number": "252-752-5000",
            "fax_number": "252-931-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 W ARLINGTON BLVD STE 210",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278345758",
            "telephone_number": "252-752-5000",
            "fax_number": "252-931-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "GEORGE",
        "middle_name": "LEE",
        "name_suffix": "III",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "NC",
            "license": "200200929",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "200200929",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89132A8",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "132A8",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, NC

Sources for this page

Verify at the official NPI Registry.