Individual provider Active NPI

Jessica Jordan, RN

  • Gerontology Nurse Practitioner
  • Huntsville, AL
National Provider Identifier
1164068235
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1-128337 Issued in AL
Practice address
3601 Cci Dr NW
Huntsville, AL 35805-2606
Phone
(256) 705-4224
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-128337 AL
Gerontology Nurse PractitionerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 363LG0600X 1-128337 AL Primary

Addresses

Primary practice location

3601 Cci Dr NW
Huntsville, AL 35805-2606

Mailing address

PO Box 18428
Huntsville, AL 35804-8428
Phone (256) 705-4224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20220114000659 AL Practitioner - Nurse Practitioner 6002208485 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Oncology Specialties, P.C.Group PAC ID 1254328495, 108 clinicians

Practice addresses (Care Compare)

3601 Cci Dr NW
Huntsville, AL 35805-2606
Phone (256) 705-4224

Hospital & facility affiliations

  • Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
  • Athens Limestone Hospital Hospital, Athens, AL, CCN 010079
  • Crestwood Medical Center Hospital, Huntsville, AL, CCN 010131

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-128337ALMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Oncology Specialties, P.C. Single Specialty CurrentSince Oct 1, 2021 Accepting new patients
Oncology Specialties PC Single Specialty Past Accepting new patients

Locations

707 W Market St
Athens, AL 35611
Phone (256) 233-5145

1107 14th Ave SE
Ste 200
Decatur, AL 35601
Phone (256) 301-1601

3601 Cci Dr NW
Huntsville, AL 35805
Phone (256) 539-3824

1 Hospital Dr SW
Ste 400
Huntsville, AL 35801
Phone (256) 713-1200

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1164068235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18428",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358048428",
            "telephone_number": "256-705-4224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3601 CCI DR NW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358052606",
            "telephone_number": "256-705-4224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JESSICA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-128337",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-128337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntsville, AL

Sources for this page

Verify at the official NPI Registry.