Individual provider Active NPI

Sydneye Jordan

  • Certified Respiratory Therapist
  • McComb, MS
National Provider Identifier
1104002724
Registry record updated Jan 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Respiratory TherapistTaxonomy code 227800000X
License
RCP1725 Issued in MS
Practice address
206 Maryland Ave
McComb, MS 39648-3926
Phone
(601) 250-4815
NPI assigned
Jan 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Respiratory Therapist 227800000X
Certified Respiratory Therapist 227800000X RCP1725 MS Primary

Addresses

Primary practice location

206 Maryland Ave
McComb, MS 39648-3926

Mailing address

3455 Bunkley Rd SW
Meadville, MS 39653-9188

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
RCP1725MSMDCertified Respiratory Therapist

NPI Registry JSON

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

{
    "created_epoch": "1200268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200268800000",
    "number": "1104002724",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 BUNKLEY RD SW",
            "city": "MEADVILLE",
            "state": "MS",
            "postal_code": "396539188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 MARYLAND AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396483926",
            "telephone_number": "601-250-4815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SYDNEYE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-14",
        "last_updated": "2008-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "227800000X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Certified",
            "state": "MS",
            "license": "RCP1725",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McComb, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2008; 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.