Mallory Odom Jordan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

904891 Issued in MS

Practice address

27 S Sixth St
Bay Springs, MS 39422-9052

Phone

(601) 764-2155

NPI assigned

Oct 2, 2021

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

Medicare fee-for-service enrollment

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jasper General HospitalGroup PAC ID 1052487105, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pro Care Home Health Home health agency, Bay Springs, MS, CCN 257096
• Jasper General Hospital Hospital, Bay Springs, MS, CCN 250018
• South Central Reg Med Ctr Hospital, Laurel, MS, CCN 250058

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BABGBD/Endpoint/BABGBD
• FHIR API: https://fhir-usa.unify.chbase.com/org/jasper-5bfe62f3

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.

• Jasper General Hospital

  • Family Medicine Physician
  • Bay Springs, MS
  • NPI 1770660920
  Medicare reassignment Care Compare group NPD
• Jasper General Hospital

  • Rural Health Clinic/Center
  • Bay Springs, MS
  • NPI 1245870823
  NPD
• Jasper General Hospital

  • Parenteral & Enteral Nutrition Supplies (DME)
  • Bay Springs, MS
  • NPI 1023118817
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Jasper General Hospital

  • Home Health Agency
  • Bay Springs, MS
  • NPI 1083715718
  Care Compare affiliation
• Jasper General Hospital

  • General Acute Care Hospital
  • Bay Springs, MS
  • NPI 1396730164
  Care Compare affiliation
• South Central Regional Medical Center

  • General Acute Care Hospital
  • Laurel, MS
  • NPI 1619973542
  Care Compare affiliation

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

{
    "created_epoch": "1633132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633132800000",
    "number": "1073285573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 S SIXTH ST",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394229052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 S SIXTH ST",
            "city": "BAY SPRINGS",
            "state": "MS",
            "postal_code": "394229052",
            "telephone_number": "601-764-2155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MALLORY",
        "middle_name": "ODOM",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-02",
        "last_updated": "2021-10-02",
        "certification_date": "2021-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jasper General Hospital
• Jasper General Hospital
• Jasper General Hospital
• Jasper General Hospital
• Jones Family Medicine Clinic, PLLC
• Laurel Physical Therapy Limited Partnership
• A Keith Lay Jr., MD
• Little Family Chiropractic, P.a.
• Paul Alan Little, DOCTOR OF CHIROPRACT
• Rebecca Little, FNP-C

• Family Nurse Practitioner in Bay Springs, MS
• Providers in Bay Springs, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.