NPIMap

Organization Active NPI

Kathleen Jordan MD PC

Doing business as Tia Silver Lake

  • Internal Medicine Physician
  • Los Angeles, CA
National Provider Identifier
1043802937
Registry record updated Mar 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
KATHLEEN JORDAN MD PC
Doing business as
Tia Silver Lake
Practice address
3921 W. Sunset Boulevard
Los Angeles, CA 90029
Phone
(646) 650-5337
NPI assigned
Feb 11, 2021
Last updated
Mar 24, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
KATHLEEN JORDAN MD PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 24, 2023

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

Authorized official

Name
Chanah SheldonNPI 1487193843
Title
Payer Relations Manager
Phone
(503) 887-5519

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X

Addresses

Primary practice location

3921 W. Sunset Boulevard
Los Angeles, CA 90029

Mailing address

30 E 23Rd St Ste 700
New York, NY 10010-4408
Phone (332) 203-0933

Other names 1

  • Tia Silver Lake Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kathleen Jordan MD PC5 organizations share this tax ID, including this one
Part of
Kathleen Jordan MD PC

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

3921 W Sunset Blvd
Los Angeles, CA 90029
Phone (646) 661-1690

30 E 23rd St
Ste 700
New York, NY 10010

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679616000000",
    "number": "1043802937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 E 23RD ST STE 700",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100104408",
            "telephone_number": "332-203-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 W. SUNSET BOULEVARD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90029",
            "telephone_number": "646-650-5337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KATHLEEN JORDAN MD PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KATHLEEN JORDAN MD PC",
        "enumeration_date": "2021-02-11",
        "last_updated": "2023-03-24",
        "certification_date": "2023-03-24",
        "status": "A",
        "authorized_official_last_name": "SHELDON",
        "authorized_official_first_name": "CHANAH",
        "authorized_official_title_or_position": "PAYER RELATIONS MANAGER",
        "authorized_official_telephone_number": "503-887-5519"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tia Silver Lake",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Tia Silver Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2023; 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.