Active NPI
Erica Jane Jordan, MSN, APRN, FNP-C
- Family Nurse Practitioner
- Trumann, AR
National Provider Identifier
1164048088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 125576
- Practice address
- 12781 Maple Grove LN
Trumann, AR 72472-9742 - Phone
- (901) 503-5758
- NPI assigned
- Jun 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 125576 | AR | |
| Family Nurse Practitioner | 363LF0000X | 125576 | AR | Primary |
Addresses
Primary practice location
12781 Maple Grove LN
Trumann, AR 72472-9742
Mailing address
12781 Maple Grove LN
Trumann, AR 72472-9742
Phone (901) 503-5758
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science - Nursing, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125576 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Family Medicine | Past | Accepting new patients |
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": "1592352000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1164048088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12781 MAPLE GROVE LN",
"city": "TRUMANN",
"state": "AR",
"postal_code": "724729742",
"telephone_number": "901-503-5758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12781 MAPLE GROVE LN",
"city": "TRUMANN",
"state": "AR",
"postal_code": "724729742",
"telephone_number": "901-503-5758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ERICA",
"middle_name": "JANE",
"credential": "MSN, APRN, FNP-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-17",
"last_updated": "2022-02-11",
"certification_date": "2022-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "125576",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "125576",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trumann, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.