Jordan Alise Blair

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

54902 Issued in CA

Practice address

1310 W Stewart Dr Ste 410
Orange, CA 92868-3855

Phone

(714) 538-8549

NPI assigned

Jun 8, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1496880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1063941359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 W STEWART DR STE 410",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928683855",
            "telephone_number": "714-538-8549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLAIR",
        "first_name": "JORDAN",
        "middle_name": "ALISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-08",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54902",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "eclinical",
            "affiliation": "N",
            "address_1": "1310 W Stewart Dr Ste 410",
            "city": "Orange",
            "state": "CA",
            "country_code": "US",
            "postal_code": "928683855",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ronnie L Blackwell, MS
• Haley Christine Blackwill, AGACNP
• Allison Elizabeth Mercer Blagojevic, MA OTR/L
• Jordan Blaine
• Jonathan B Blair, MD
• Kere Anne Blair, M.A., MFTI
• Thomas L. Blair, INTERNAL MEDICINE
• Carolyn Fox Blakemore
• Jacqueline Olivia Blancas
• Riley Sebastian Blanchard

• Physician Assistant in Orange, CA
• Providers in Orange, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 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.