Jermaine Jordan, STNA

Primary specialty

Assisted Living Facility (Behavioral Disturbances)Taxonomy code 3104A0630X

License

CNA312402 Issued in FL

Practice address

1210 Retreat View Cir
Sanford, FL 32771-7276

Phone

(216) 772-9101

NPI assigned

Nov 7, 2016

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478476800000",
    "number": "1104368240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 RETREAT VIEW CIR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717276",
            "telephone_number": "216-772-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 RETREAT VIEW CIR",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717276",
            "telephone_number": "216-772-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JERMAINE",
        "credential": "STNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "3104A0630X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Behavioral Disturbances",
            "state": "FL",
            "license": "CNA312402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacob Johnson, D.M.D.
• Valerie S Johnson
• Garanne Jones, L.M.T
• Kassidy Jones
• Mary Charlotte Jones
• Joseph Boyle Inc
• Meena A Joseph, M.D.
• S K Joshi, M.D., P.A.
• Candace Joshnick
• Josie Velasco OD PA

• Assisted Living Facility (Behavioral Disturbances) in Sanford, FL
• Providers in Sanford, FL by specialty
• Assisted Living Facility (Behavioral Disturbances) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.