Dashiell Jordan, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

TD171104 Issued in ME

Practice address

99 Campus Ave Ste 201
Lewiston, ME 04240-6045

Phone

(207) 777-8810

Fax

(207) 777-8155

NPI assigned

Jun 15, 2010

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dashiell J Slabbert Former name

Medicare fee-for-service enrollment

Enrolled in ME

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• St. Mary's Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1447226584
  Medicare reassignment NPD
• St. Mary's Regional Medical Center

  dba St. Mary's d'Youville Pavilion

  • Skilled Nursing Facility
  • Lewiston, ME
  • NPI 1952306524
  NPD

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

{
    "created_epoch": "1276560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053632901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1638",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122011638",
            "telephone_number": "207-777-4111",
            "fax_number": "207-783-6660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 CAMPUS AVE STE 201",
            "city": "LEWISTON",
            "state": "ME",
            "postal_code": "042406045",
            "telephone_number": "207-777-8810",
            "fax_number": "207-777-8155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DASHIELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-15",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "TD171104",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1053632901",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DASHIELL",
            "last_name": "SLABBERT",
            "middle_name": "J",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Janean Jones
• Judith Goss Jones, RDH
• Maury-Anne Jones
• Sarah M Jones, FNP-C
• Amanda Rose Jordan, RDH
• Hannah Jordan, CADC
• Kathryn Jordan, RN
• Rebecca Dawn Jordan, RN
• James Joseph
• Aleta Joy, CNM

• Family Medicine Physician in Lewiston, ME
• Providers in Lewiston, ME by specialty
• Family Medicine Physician in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.