Individual provider Active NPI

Lesa Jordan, MD

  • Emergency Medicine Physician
  • Memphis, TN
National Provider Identifier
1073560652
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18383 Issued in MS
Practice address
710 N Main St
Memphis, TN 38107-2310
Phone
(901) 626-2266
NPI assigned
May 28, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35942 TN
Emergency Medicine Physician 207P00000X 18383 MS Primary

Addresses

Primary practice location

710 N Main St
Memphis, TN 38107-2310

Mailing address

710 N Main St
Memphis, TN 38107-2310
Phone (901) 626-2266

Other identifiers 3

IdentifierTypeStateIssuer
3880023MedicaidTN
P00427604OtherRAILROAD MCR
04939709MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040824001012 MS Practitioner - Internal MedicinePractitioner - Emergency Medicine 4880668995 Reassigns benefits to 1 organization
I20050519000450 TN Practitioner - Internal MedicinePractitioner - Emergency Medicine 4880668995 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
18383MSMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Olive Branch Urgent Care #1 LLC Current Accepting new patients
Landmark Medical of Tennessee PC CurrentSince Feb 7, 2022 Accepting new patients
Landmark Medical of Tennessee PC CurrentSince Feb 7, 2022 Accepting new patients
Somerville Emergency Services, LLC Emergency Medicine Past Accepting new patients
Emergency Coverage, LLC Emergency Medicine Past Accepting new patients
Emergency Coverage Services, PC Past Accepting new patients
Finest Emergency Physicians Emergency Medicine Past Accepting new patients
Red Hills Emergency Physicians Emergency Medicine Past Accepting new patients
McLemore Emergency Physicians Emergency Medicine PastSince Dec 18, 2007 Accepting new patients

Locations

7755 Center Ave
Ste 630
Huntington Beach, CA 92647
Phone (877) 240-3112

5142 Goodman Rd
Ste 107
Olive Branch, MS 38654
Phone (662) 874-5755

210 Westwood Pl
Ste 110
Brentwood, TN 37027
Phone (615) 206-2462

Interoperability endpoints

  • Direct secure messaging: lejordan@landmarkhealth-direct.org

Organizations & group practices 10

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": "1148774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1073560652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 N MAIN ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381072310",
            "telephone_number": "901-626-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 N MAIN ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381072310",
            "telephone_number": "901-626-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LESA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-28",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "35942",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MS",
            "license": "18383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3880023",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P00427604",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04939709",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.