Active NPI
William D Jordan Jr., MD
- Vascular Surgery Physician
- Augusta, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vascular Surgery Physician
- License
- 37578
- Practice address
- 1120 15TH St
Augusta, GA 30912-1013 - Phone
- (706) 721-8623
- NPI assigned
- Jul 3, 2006
- Last updated
- Jul 12, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 37578 | GA | Primary |
| Vascular Surgery Physician | 2086S0129X | 14678 | AL |
Addresses
Primary practice location
1120 15TH St
Augusta, GA 30912-1013
Mailing address
1120 15TH St # Or6000
Augusta, GA 30912-0004
Phone (706) 721-3813
Other practice location 1
1365 Clifton Rd NE
TEC Building A, Room 2200
Atlanta, GA 30322-1013
Phone (404) 727-1994
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E92967 | Other | AL | VIVA |
| 000027366 | Other | AL | BLUE CROSS |
| 770000637 | Other | AL | RAILROAD MEDICARE |
| 000027366 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL, GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Vascular Surgery
- Education
- Emory University School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1120 15TH St
Augusta, GA 30912-0004
Phone (706) 721-8623
5150 Stilesboro N W Rd
Suite 220
Kennesaw, GA 30152-7742
Phone (770) 424-8222
989 Saint Sebastian Way
Augusta, GA 30912-0004
Phone (706) 721-2171
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.93 of 100
- Quality
- 82.14
- Promoting interoperability
- 100
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| University of Alabama Health Services Foundation, PC. | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients | |
| Emory Medical Care Foundation Inc | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| The Emory Clinic Inc | Current | Accepting new patients | |
| Wellstar Medical Group, LLC | Current | Accepting new patients | |
| Au Medical Associates Inc | Current | Accepting new patients |
Locations
619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405
619 19th St S
Birmingham, AL 35249
1365 Clifton Rd NE
Atlanta, GA 30322
Phone (404) 778-7525
1365 Clifton Rd NE
Bldg A
Atlanta, GA 30322
Phone (404) 778-3280
80 Jesse Hill Jr Dr SE
Atlanta, GA 30303
Phone (404) 616-4370
1120 15th St
Augusta, GA 30912
Phone (706) 721-3873
1120 15th St
#6000
Augusta, GA 30912
Phone (706) 721-3813
5150 Stilesboro Rd NW
Ste 220
Kennesaw, GA 30152
Phone (770) 424-8222
Interoperability endpoints
- wjordan43312@direct.emory.org
Organizations & group practices 8
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba WellStar Family Medicine ACW
- Family Medicine Physician
- Kennesaw, GA
- NPI 1558664003
-
- Multi-Specialty Clinic/Center
- Augusta, GA
- NPI 1841230620
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1063452381
-
- Internal Medicine Physician
- Atlanta, GA
- NPI 1396798229
-
- Multi-Specialty Clinic/Center
- Birmingham, AL
- NPI 1093768723
-
dba Augusta University Health West Wheeler
- Durable Medical Equipment & Medical Supplies
- Augusta, GA
- NPI 1114574126
-
- Diagnostic Radiology Physician
- Atlanta, GA
- NPI 1225294739
-
- Multi-Specialty Clinic/Center
- Marietta, GA
- NPI 1275992240
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Augusta, GA
- NPI 1437135902
-
dba Wound Care Center
- General Acute Care Hospital
- Aiken, SC
- NPI 1447437157
-
dba Aiken Regional Medical Center
- General Acute Care Hospital
- Aiken, SC
- NPI 1467448498
-
dba Aiken Regional Medical Centers Neuro Physician Services
- Neurological Surgery Physician
- Aiken, SC
- NPI 1942610928
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151884800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689120000000",
"number": "1134159668",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST # OR6000",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004",
"telephone_number": "706-721-3813"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309121013",
"telephone_number": "706-721-8623"
}
],
"practiceLocations": [
{
"address_1": "1365 Clifton Rd NE",
"address_2": "TEC Building A, Room 2200",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303221013",
"country_code": "US",
"telephone_number": "404-727-1994",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JORDAN",
"first_name": "WILLIAM",
"middle_name": "D",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-03",
"last_updated": "2023-07-12",
"certification_date": "2023-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "GA",
"license": "37578",
"primary": true
},
{
"code": "2086S0129X",
"taxonomy_group": "",
"desc": "Surgery, Vascular Surgery",
"state": "AL",
"license": "14678",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIVA",
"identifier": "E92967",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "000027366",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "770000637",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000027366",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.