Individual provider Active NPI

Jordan Nicole Lindon, DPT, PT

  • Physical Therapist
  • Edgewood, KY
National Provider Identifier
1083248462
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007908 Issued in KY
Practice address
520 Garden Way
Edgewood, KY 41017
Phone
(859) 835-4373
NPI assigned
Feb 25, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTL0017143 CO
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT007908 KY Primary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X PT-007908 KY

Addresses

Primary practice location

520 Garden Way
Edgewood, KY 41017

Mailing address

520 Garden Way
Edgewood, KY 41017-3387
Phone (859) 835-4373

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240403000825 KY Practitioner - Physical Therapist in Private Practice 8426476573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Life Home Therapy, LLCGroup PAC ID 0941637219, 2 clinicians

Practice addresses (Care Compare)

220 Thomas More Pkwy
Crestview Hills, KY 41017-3424
Phone (859) 331-0474

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-007908KYMDSports Medicine (Physical Medicine & Rehabilitation) Physician
PTL0017143COMDPhysical Therapist
PT007908KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Life Home Therapy, LLC Single Specialty CurrentSince Feb 15, 2024 Accepting new patients

Locations

220 Thomas More Pkwy
Crestview Hills, KY 41017
Phone (859) 331-0474

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": "1582588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707955200000",
    "number": "1083248462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 GARDEN WAY",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "410173387",
            "telephone_number": "859-835-4373"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 GARDEN WAY",
            "city": "EDGEWOOD",
            "state": "KY",
            "postal_code": "41017",
            "telephone_number": "859-835-4373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDON",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "DPT, PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-25",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "PTL0017143",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "PT007908",
            "primary": true
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "KY",
            "license": "PT-007908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewood, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.