Jordan E Taylor, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NP729A Issued in ID

Practice address

1090 W Park PL
Coeur D Alene, ID 83814-2785

Phone

(208) 215-2005

NPI assigned

Oct 27, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 10

Other names 1

• Jordan E Malloy Former name

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Dirne Health Centers, Inc.

  dba Heritage Health Main

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1285686477

  Family

  Medicare reassignment NPD
• Dirne Health Centers, Inc

  dba Heritage Health Kellogg

  • Federally Qualified Health Center (FQHC)
  • Kellogg, ID
  • NPI 1487076048

  Family

  NPD
• Dirne Health Centers, Inc.

  dba Heritage Health CFHL CDA

  • Federally Qualified Health Center (FQHC)
  • Coeur d'Alene, ID
  • NPI 1194397240
  NPD
• Coeur D'Alene Pediatrics PA

  • Pediatrics Physician
  • Coeur d'Alene, ID
  • NPI 1255496980
  NPD (past)

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1144306549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1387",
            "city": "HAYDEN",
            "state": "ID",
            "postal_code": "838351387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1090 W PARK PL",
            "city": "COEUR D ALENE",
            "state": "ID",
            "postal_code": "838142785",
            "telephone_number": "208-215-2005"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 W Ironwood Dr",
            "address_2": "Suite 155",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838142656",
            "country_code": "US",
            "telephone_number": "208-667-0585",
            "fax_number": "208-667-0876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JORDAN",
        "middle_name": "E",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP60904961",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "ID",
            "license": "NP729A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010153955",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1047507",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144306549",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP708ID",
            "state": "AK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807343600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9653353",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARNP",
            "identifier": "AP60904961",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "NPXN3",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "000010153954",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "NPXN2",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "MALLOY",
            "middle_name": "E",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Reed W. Tate
• Deemarla Tavares, LMSW
• Taylor Mobile Therapy, LLC
• Christopher Taylor
• Ellen Jane Taylor, ARNP
• Shawn William Taylor, D.O.
• Christina Tempesta
• Joel D Tenbrink, PT, ATC
• Gladys Liliana Tenney
• Francesca Terracciano, LPC

• Pediatric Nurse Practitioner in Coeur d'Alene, ID
• Providers in Coeur d'Alene, ID by specialty
• Pediatric Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.