Individual provider Active NPI

Danielle Jordan

  • Certified Registered Nurse Anesthetist
  • Bullhead City, AZ
National Provider Identifier
1164284337
Registry record updated Jan 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
148104 Issued in FL
Practice address
2735 Silver Creek Rd
Bullhead City, AZ 86442-7924
Phone
(928) 763-2273
NPI assigned
Jan 24, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 148104 FL Primary

Addresses

Primary practice location

2735 Silver Creek Rd
Bullhead City, AZ 86442-7924

Mailing address

12232 SW 148TH Ter
Miami, FL 33186-7426
Phone (786) 461-3140

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, OR2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240812002179 AZ Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799223509 Reassigns benefits to 1 organization
I20260312003117 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 5799223509 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Associates Northwest LLCGroup PAC ID 7618908484, 80 clinicians
Antigua Anesthesia Management, LLCGroup PAC ID 3870908676, 39 clinicians

Practice addresses (Care Compare)

1508 Division St
Suite 15
Oregon City, OR 97045-1583
Phone (503) 692-4537

2735 Silver Creek Rd
Bullhead City, AZ 86442-7924
Phone (928) 763-2273

Hospital & facility affiliations

  • Western Arizona Regional Medical Center Hospital, Bullhead City, AZ, CCN 030101
  • Kingman Regional Medical Center Hospital, Kingman, AZ, CCN 030055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
148104FLMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Antigua Anesthesia Management, LLC CurrentSince Jul 6, 2024 Accepting new patients
Emerald Valley Anesthesia Nurse Anesthetist, Certified Registered CurrentSince Feb 1, 2026 Accepting new patients

Locations

2735 Silver Creek Rd
Bullhead City, AZ 86442
Phone (520) 763-2273

Organizations & group practices 3

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": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1164284337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12232 SW 148TH TER",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331867426",
            "telephone_number": "786-461-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2735 SILVER CREEK RD",
            "city": "BULLHEAD CITY",
            "state": "AZ",
            "postal_code": "864427924",
            "telephone_number": "928-763-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "148104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bullhead City, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.