Timothy D. Jordan, MD, PLLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

9800583 Issued in NC

Legal business name

TIMOTHY D. JORDAN, MD, PLLC

Practice address

2709 Blue Ridge Rd
Suite 100
Raleigh, NC 27607-6462

Phone

(919) 782-5400

Fax

(919) 782-1680

NPI assigned

Nov 10, 2006

Organization subpart

No

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

Authorized official

Name

Timothy D Jordan, MDNPI 1982801130

Title

Member

Phone

(919) 782-5400

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Timothy D Jordan, MD

  • Ophthalmology Physician
  • Raleigh, NC
  • NPI 1982801130
  NPD Authorized official

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043381320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2709 BLUE RIDGE RD",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076462",
            "telephone_number": "919-782-5400",
            "fax_number": "919-782-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2709 BLUE RIDGE RD",
            "address_2": "SUITE 100",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276076462",
            "telephone_number": "919-782-5400",
            "fax_number": "919-782-1680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIMOTHY D. JORDAN, MD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "919-782-5400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "NC",
            "license": "9800583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1038G",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891038G",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Carolyn Timberlake, DDS
• Phillip Zachary Timmons, M.D.
• Timothy B. Hart, MD, PA
• Timothy B. Naomi, D.D.S., P.a.
• Timothy C. Chang, DDS, PLLC (Chang Family Dentistry)
• Timothy Thomas DDS PA (Rolling Ridge Dentistry)
• Tina Gupta DDS PA
• Amanda Tindall, BCBA, LBA
• Arnette Tineo, RN
• Brandon Lee Tingley, PA-C

• Ophthalmology Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Ophthalmology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.