Jordan Physician Associates, Inc.

Key facts

NPI

1124562483

Entity type

Organization (NPI type 2)

Primary specialty

Diagnostic Radiology Physician 2085R0202X

Legal business name

JORDAN PHYSICIAN ASSOCIATES, INC.

Practice address

275 Sandwich St
Plymouth, MA 02360-2183

Phone

(508) 830-2401

Fax

(508) 830-1131

NPI assigned

Dec 6, 2016

Organization subpart

Yes

Parent organization (as reported)

JORDAN PHYSICIAN ASSOCIATES, INC.

Authorized official

Name

Catherine J Grey

Title

Credentialing Specialist

Phone

(508) 830-2401

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Jordan Physician Associates, Inc. Family Medicine Physician · Plymouth, MA · NPI 1538145131
  NPPES parent name

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Beth Israel Deaconess Hospital Plymouth, Inc. Community Based Hospice Care Agency · Plymouth, MA · NPI 1164535084
  NPD member Member Of

National Provider Directory

Part of

Affilliated Medical Pra

Specialties & licenses

Addresses

Other identifiers

Other names

• BIDH-Plymouth Radiology Doing business as

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 19, 2020.

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582070400000",
    "number": "1124562483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 SANDWICH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602183",
            "telephone_number": "508-830-2401",
            "fax_number": "508-830-1131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SANDWICH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602183",
            "telephone_number": "508-830-2401",
            "fax_number": "508-830-1131"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "45 Resnik Rd",
            "address_purpose": "LOCATION",
            "city": "Plymouth",
            "state": "MA",
            "postal_code": "023604844",
            "country_code": "US",
            "telephone_number": "508-830-2401",
            "fax_number": "508-830-1131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JORDAN PHYSICIAN ASSOCIATES, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JORDAN PHYSICIAN ASSOCIATES, INC.",
        "enumeration_date": "2016-12-06",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A",
        "authorized_official_last_name": "GREY",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "508-830-2401"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072193W",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BIDH-Plymouth Radiology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BIDH-Plymouth Radiology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Plymouth, MA

• Heather E Jones
• John Francis Jones
• Lillian Jones, RN
• Erik Jonsberg, LICSW
• Jennifer Michelle Jope, MA
• Jordan Physician Associates, Inc.
• Jordan Physician Associates, Inc.
• Jordan Physician Associates, Inc.
• Jessica Jordan
• Amy Jorud, LICSW

All providers in Plymouth, MA · Diagnostic Radiology Physician in Massachusetts