Individual provider Active NPI

Jordan Harlow, NP

  • Nurse Practitioner
  • Moscow, ID
National Provider Identifier
1073303277
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2171158 Issued in ID
Practice address
213 N Main St
Moscow, ID 83843-2700
Phone
(208) 882-7565
NPI assigned
May 9, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2171158 ID Primary

Addresses

Primary practice location

213 N Main St
Moscow, ID 83843-2700

Mailing address

PO Box 3687
Coeur D Alene, ID 83816-2529
Phone (208) 819-2183

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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

Enrollment IDStateProvider typePAC IDDetails
I20251106004955 ID Practitioner - Nurse Practitioner 0941790075 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moscow Medical, P.a.Group PAC ID 8325006463, 4 clinicians

Practice addresses (Care Compare)

213 N Main St
Moscow, ID 83843-2700
Phone (208) 882-7565

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Spokane Valley, WA, CCN 507021
  • Gritman Medical Center Hospital, Moscow, ID, CCN 131327
  • Pullman Regional Hospital Hospital, Pullman, WA, CCN 501331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2171158IDMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Moscow Medical, P.a. CurrentSince Sep 29, 2025 Accepting new patients

Locations

213 N Main St
Moscow, ID 83843
Phone (208) 882-2932

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FEIBCA/Endpoint/FEIBCA

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1746748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1073303277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3687",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838162529",
            "telephone_number": "208-819-2183",
            "fax_number": "208-209-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N MAIN ST",
            "city": "MOSCOW",
            "state": "ID",
            "postal_code": "838432700",
            "telephone_number": "208-882-7565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARLOW",
        "first_name": "JORDAN",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "ID",
            "license": "2171158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moscow, ID

Sources for this page

Verify at the official NPI Registry.