Individual provider Active NPI

Jordan Alexandra Conner, FNP-BC

  • Family Nurse Practitioner
  • Ahoskie, NC
National Provider Identifier
1154056083
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5016588 Issued in NC
Practice address
120 Health Center Dr
Ahoskie, NC 27910-8161
Phone
(252) 332-3548
NPI assigned
Jul 25, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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 5016588 NC Primary

Addresses

Primary practice location

120 Health Center Dr
Ahoskie, NC 27910-8161

Mailing address

120 Health Center Dr
Ahoskie, NC 27910-8161
Phone (252) 209-3911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20220929003726 NC Practitioner - Nurse Practitioner 0648656561 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Roanoke Chowan Community Health Center Inc 35 clinicians

Practice addresses (Care Compare)

120 Health Ctr Dr
Ahoskie, NC 27910-8161
Phone (252) 332-3548

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Roanoke Chowan Community Health Center Inc Current Accepting new patients
Vidant Medical Group LLC CurrentSince Sep 15, 2022 Accepting new patients
Roanoke Chowan Community Health Center Inc CurrentSince Jul 10, 2024 Accepting new patients
Roanoke Chowan Community Health Center Inc CurrentSince Jul 10, 2024 Accepting new patients

Locations

120 Health Center Dr
Ahoskie, NC 27910
Phone (252) 209-0237

226 Academy St S
Ahoskie, NC 27910
Phone (252) 209-3911

113 Hertford County High Rd
#B
Ahoskie, NC 27910
Phone (252) 209-3375

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

305 Beechwood Blvd
Murfreesboro, NC 27855
Phone (252) 398-3323

Interoperability endpoints

  • Direct secure messaging: jconner406304@direct.ecuhealth.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1658707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1154056083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-209-3911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HEALTH CENTER DR",
            "city": "AHOSKIE",
            "state": "NC",
            "postal_code": "279108161",
            "telephone_number": "252-332-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONNER",
        "first_name": "JORDAN",
        "middle_name": "ALEXANDRA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-25",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5016588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ahoskie, NC

Sources for this page

Verify at the official NPI Registry.