Individual provider Active NPI

Heather Jordan

  • Family Nurse Practitioner
  • Longview, TX
National Provider Identifier
1104609965
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1130883 Issued in TX
Practice address
515 N 3Rd St
Longview, TX 75601-6546
Phone
(903) 475-3474
Fax
(903) 367-0300
NPI assigned
Aug 16, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1130883 TX Primary

Addresses

Primary practice location

515 N 3Rd St
Longview, TX 75601-6546

Mailing address

582 County Road 307
De Berry, TX 75639-3020

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230907001400 TX Practitioner - Nurse Practitioner 2062876246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wound Management Specialists LLC 157 clinicians

Practice addresses (Care Compare)

1600 S Henderson Blvd
Kilgore, TX 75662-3518
Phone (903) 758-1818

Hospital & facility affiliations

  • White Rock Medical Center Hospital, Dallas, TX, CCN 450678
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
  • Nacogdoches Medical Center Hospital, Nacogdoches, TX, CCN 450656

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wound Management Specialists, LLC CurrentSince Aug 1, 2023 Accepting new patients
Healthcare Plus Limited Liability Company CurrentSince Jan 3, 2026 Accepting new patients

Locations

778 Liberty Rd
Flowood, MS 39232
Phone (601) 914-9620

434 Katherine Dr
Flowood, MS 39232
Phone (769) 216-3346

1600 S Henderson Blvd
Kilgore, TX 75662
Phone (903) 215-3149

515 N 3rd St
Longview, TX 75601
Phone (903) 215-3149

2901 4th St
Longview, TX 75605
Phone (281) 371-1800

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1692144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1104609965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "582 COUNTY ROAD 307",
            "city": "DE BERRY",
            "state": "TX",
            "postal_code": "756393020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N 3RD ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756016546",
            "telephone_number": "903-475-3474",
            "fax_number": "903-367-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-16",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1130883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.