Individual provider Active NPI

Amos Jordan Jr.

  • Prosthetics Case Management
  • Knightdale, NC
National Provider Identifier
1114875374
Registry record updated Mar 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
C20217 Issued in NC
Practice address
1110 Cannonball Run Apt 206
Knightdale, NC 27545-6655
Phone
(301) 633-0510
NPI assigned
Mar 20, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case ManagementGroup: 193200000X MULTI-SPECIALTY GROUP 1744P3200X C20217 NC Primary

Addresses

Primary practice location

1110 Cannonball Run Apt 206
Knightdale, NC 27545-6655

Mailing address

1110 Cannonball Run Apt 206
Knightdale, NC 27545-6655
Phone (301) 633-0510

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
C20217NCMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1773964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1114875374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 CANNONBALL RUN APT 206",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456655",
            "telephone_number": "301-633-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 CANNONBALL RUN APT 206",
            "city": "KNIGHTDALE",
            "state": "NC",
            "postal_code": "275456655",
            "telephone_number": "301-633-0510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "AMOS",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-03-20",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "NC",
            "license": "C20217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knightdale, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; 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.