Individual provider Active NPI

Labrittany J Jordan, FNP-C

  • Family Nurse Practitioner
  • Meridian, MS
National Provider Identifier
1154142735
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
906757 Issued in MS
Practice address
1104 62ND St
Meridian, MS 39305-1255
Phone
(601) 934-1236
NPI assigned
Oct 17, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.0041240 OH
Family Nurse Practitioner 363LF0000X 906757 MS Primary
Family Nurse Practitioner 363LF0000X 9471793 ID
Family Nurse Practitioner 363LF0000X 1221416 TX
Family Nurse Practitioner 363LF0000X ARNP.AP.70119299-NP WA

Addresses

Primary practice location

1104 62ND St
Meridian, MS 39305-1255

Mailing address

1104 62ND St
Meridian, MS 39305-1255
Phone (601) 934-1236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, TX, OH, ID, CT, SC6 enrollments
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 6

Enrollment IDStateProvider typePAC IDDetails
I20250429001272 MS Practitioner - Nurse Practitioner 6800312273 Reassigns benefits to 1 organization
I20260131000865 TX Practitioner - Nurse Practitioner 6800312273 Reassigns benefits to 1 organization
I20260205001381 OH Practitioner - Nurse Practitioner 6800312273 Reassigns benefits to 1 organization
I20260210004095 ID Practitioner - Nurse Practitioner 6800312273 Reassigns benefits to 1 organization
I20260216000518 CT Practitioner - Nurse Practitioner 6800312273 Reassigns benefits to 1 organization
I20260625002343 SC Practitioner - Nurse Practitioner 6800312273 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1104 62ND St
Meridian, MS 39305-1255

200 Oceangate
Suite 100
Long Beach, CA 90802-4316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
906757MSMDFamily Nurse Practitioner
APRN.CNP.0041240OHMDFamily Nurse Practitioner
1221416TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Molina Care Connections, LLC. CurrentSince Jun 2, 2025 Accepting new patients

Locations

200 Oceangate
Ste 100
Long Beach, CA 90802
Phone (562) 435-3666

175 Scott Swamp Rd
Farmington, CT 06032
Phone (860) 249-6752

950 W Bannock St
Ste 1100
Boise, ID 83702
Phone (201) 293-7689

188 E Capitol St
Ste 700
Jackson, MS 39201
Phone (844) 809-8438

3000 Corporate Exchange Dr
Columbus, OH 43231
Phone (614) 942-3042

115 Fairchild St
Ste 340
Daniel Island, SC 29492
Phone (843) 680-1943

5605 N MacArthur Blvd
Ste 400
Irving, TX 75038
Phone (972) 536-7265

1660 Westridge Cir N
Irving, TX 75038
Phone (214) 467-9787

Interoperability endpoints

  • Direct secure messaging: ljordan18870@direct-prd.molinahealthcare.com

Organizations & group practices 1

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": "1729123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1154142735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 62ND ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393051255",
            "telephone_number": "601-934-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 62ND ST",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393051255",
            "telephone_number": "601-934-1236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LABRITTANY",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-17",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0041240",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "906757",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "9471793",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1221416",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "ARNP.AP.70119299-NP",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

Verify at the official NPI Registry.