Sybil Yvette Jordan

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LP60860965 Issued in WA

Practice address

1233 Poindexter Ave
Bremerton, WA 98312-4334

Phone

(360) 373-1992

NPI assigned

Jan 29, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kitsap Mental Health Services

  • Community/Behavioral Health Agency
  • Bremerton, WA
  • NPI 1033268008
  NPD (past)

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

{
    "created_epoch": "1580256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580256000000",
    "number": "1073144093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1233 POINDEXTER AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983124334",
            "telephone_number": "360-373-1992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 POINDEXTER AVE",
            "city": "BREMERTON",
            "state": "WA",
            "postal_code": "983124334",
            "telephone_number": "360-373-1992"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SYBIL",
        "middle_name": "YVETTE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-29",
        "last_updated": "2020-01-29",
        "certification_date": "2020-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WA",
            "license": "LP60860965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanayia Napier Jones
• Tristan Ray Jones
• Mary Castillo Jordan, M.A., MHP, AAC
• Patrick Burgermeister Jordan, L.M.P.
• Richelle L Jordan, MA
• Tate Jorgensen
• Elyan Rain Josa
• Jacqueline Joseph
• Brenda Jowdy
• Kimberly Joyce

• Licensed Practical Nurse in Bremerton, WA
• Providers in Bremerton, WA by specialty
• Licensed Practical Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 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.