Individual provider Active NPI

Lauren Barket Jordan, CNM

  • Advanced Practice Midwife
  • Fredericksburg, VA
National Provider Identifier
1104188085
Registry record updated Nov 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
0024170128 Issued in VA
Practice address
1101 Sam Perry Blvd Ste 401
Fredericksburg, VA 22401-4466
Phone
(540) 940-2000
NPI assigned
Jun 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 0024170128 VA Primary

Addresses

Primary practice location

1101 Sam Perry Blvd Ste 401
Fredericksburg, VA 22401-4466

Mailing address

1101 Sam Perry Blvd Ste 401
Fredericksburg, VA 22401-4466
Phone (540) 940-2000

Other practice location 1

9755 Courthouse Rd Ste 104
Spotsylvania, VA 22553-1984
Phone (540) 940-2000

Other practice location 2

4000 Coliseum Dr Ste 280
Hampton, VA 23666-5974
Phone (757) 827-2455

Other identifiers 1

IdentifierTypeStateIssuer
1104188085MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120810000431 VA Practitioner - Certified Nurse Midwife (CNM) 7416103247 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Edge PastSince Aug 9, 2020 Accepting new patients
Elite Gynecology and Wellness LLC PastSince Aug 30, 2021 Accepting new patients
Nova Access Surgery PLLC Past Accepting new patients
Mary Washington Healthcare Physicians Past Accepting new patients

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/23133/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1339718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1104188085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD STE 401",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014466",
            "telephone_number": "540-940-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD STE 401",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014466",
            "telephone_number": "540-940-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9755 Courthouse Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Spotsylvania",
            "state": "VA",
            "postal_code": "225531984",
            "country_code": "US",
            "telephone_number": "540-940-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4000 Coliseum Dr Ste 280",
            "address_purpose": "LOCATION",
            "city": "Hampton",
            "state": "VA",
            "postal_code": "236665974",
            "country_code": "US",
            "telephone_number": "757-827-2455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LAUREN",
        "middle_name": "BARKET",
        "name_prefix": "Mrs.",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-15",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "VA",
            "license": "0024170128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1104188085",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fredericksburg, VA

Sources for this page

Verify at the official NPI Registry.