Organization Active NPI

Sally C Jordan, MD

  • Specialist
  • Scarsdale, NY
National Provider Identifier
1063534907
Registry record updated Dec 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SALLY C JORDAN, MD
Practice address
700 Post Rd
Scarsdale, NY 10583-5063
Phone
(914) 472-5141
Fax
(845) 207-9378
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 26, 2007

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

Authorized official

Name
Ms. Coumba Sam
Title
Billling Manger
Phone
(914) 588-9862

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

700 Post Rd
Scarsdale, NY 10583-5063

Mailing address

700 Post Rd
Scarsdale, NY 10583-5063
Phone (914) 472-5141

Other identifiers 1

IdentifierTypeStateIssuer
154001-1OtherNYLICENSE

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198627200000",
    "number": "1063534907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 POST RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835063",
            "telephone_number": "914-472-5141",
            "fax_number": "845-207-9378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 POST RD",
            "city": "SCARSDALE",
            "state": "NY",
            "postal_code": "105835063",
            "telephone_number": "914-472-5141",
            "fax_number": "845-207-9378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALLY C JORDAN, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-12-26",
        "status": "A",
        "authorized_official_last_name": "SAM",
        "authorized_official_first_name": "COUMBA",
        "authorized_official_title_or_position": "BILLLING MANGER",
        "authorized_official_telephone_number": "914-588-9862",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "154001-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scarsdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2007; 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.