Jessica Jordan OD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

JESSICA JORDAN OD LLC

Practice address

1771 Dunlawton Ave
Port Orange, FL 32127-4757

Phone

(386) 304-7360

NPI assigned

Feb 23, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Jessica M Jordan, OD

Title

Optometirst

Phone

(808) 286-5529

Specialties & licenses 1

Addresses

Tax ID family

Dr Jessica'S Eyes That Smile Optometry2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Jessica Jordan OD LLC

  • Optometrist
  • Port Orange, FL
  • NPI 1790668614
  NPD tax ID

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

{
    "created_epoch": "1645574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1645574400000",
    "number": "1073269577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 YORKTOWNE BLVD APT 4904",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321296033",
            "telephone_number": "808-286-5529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1771 DUNLAWTON AVE",
            "city": "PORT ORANGE",
            "state": "FL",
            "postal_code": "321274757",
            "telephone_number": "386-304-7360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA JORDAN OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-02-23",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OPTOMETIRST",
        "authorized_official_telephone_number": "808-286-5529",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JC Mobile Phlebotomy Services, LLC
• Wislyne Jean-Pierre
• Kelly Jenkins, PT, DPT
• Lane Edward Jennings Jr., LCSW, MCAP
• Elise Jernigan
• Jessica Jordan OD LLC
• Dana Jickell, AUD
• Yolanda Renay Jiles
• Raxitkumar Jinjuvadia, MD
• Joanne D Saxour MD

• Optometrist in Port Orange, FL
• Providers in Port Orange, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; 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.