Raven Jordan, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

3015160 Issued in KY

Practice address

215 N Allison Ave
Barbourville, KY 40906-1336

Phone

(606) 546-9287

NPI assigned

Oct 7, 2020

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 KY

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Barbourville Family Health CenterGroup PAC ID 7416867387, 30 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Barbourville Family Health Center

  • Rural Health Clinic/Center
  • Barbourville, KY
  • NPI 1275786071
  Medicare reassignment Care Compare group NPD
• Barbourville Family Health Center

  • Rural Health Clinic/Center
  • Barbourville, KY
  • NPI 1801872882
  NPD
• Barbourville Family Health Center

  • Rural Health Clinic/Center
  • Corbin, KY
  • NPI 1073599056
  NPD (past)

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

{
    "created_epoch": "1602028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1083211544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 GRANGER CT",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409067212",
            "telephone_number": "606-627-4235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 N ALLISON AVE",
            "city": "BARBOURVILLE",
            "state": "KY",
            "postal_code": "409061336",
            "telephone_number": "606-546-9287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "RAVEN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-07",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3015160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip Jacob Janutolo, ATC
• JL Collins Enterprises Inc.
• Jill M Johnson, APRN
• Patrick Neil Jones
• Carla J Jordan, M.A., CFY-SLP, ATP
• Bailey Karr
• Kids First Dental Care, LLC
• Kids First Dental Services, Inc
• Stephanie A King, LPCA
• Jade E Knight, LCSW

• Nurse Practitioner in Barbourville, KY
• Providers in Barbourville, KY by specialty
• Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 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.