Individual provider Active NPI

Sheree Jordan

  • Registered Nurse
  • Elkins, WV
National Provider Identifier
1073379491
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
32780 Issued in WV
Practice address
1408 Harrison Ave
Elkins, WV 26241-3325
Phone
(304) 636-4390
NPI assigned
Feb 23, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 32780 WV Primary

Addresses

Primary practice location

1408 Harrison Ave
Elkins, WV 26241-3325

Mailing address

51 Riverview Dr
Petersburg, WV 26847-9417

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
32780WVMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Select in Home Services, Inc. CurrentSince Feb 25, 2024 Accepting new patients

Locations

1408 Harrison Ave
Elkins, WV 26241
Phone (304) 636-4390

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.

NPI Registry JSON

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1073379491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 RIVERVIEW DR",
            "city": "PETERSBURG",
            "state": "WV",
            "postal_code": "268479417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1408 HARRISON AVE",
            "city": "ELKINS",
            "state": "WV",
            "postal_code": "262413325",
            "telephone_number": "304-636-4390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SHEREE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "32780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkins, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; 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.