Jordan Landry

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

122037 Issued in IA

Practice address

4730 Elmore Ave Ste 1
Davenport, IA 52807-3658

Phone

(563) 362-3709

NPI assigned

Dec 14, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA, IL, NM3 enrollments

Enrollment records 3

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Physical Therapy at Dawn LLCGroup PAC ID 0042221889, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Athletico LTD

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028

  IA

  Medicare reassignment Care Compare group NPD
• Physical Therapy at Dawn, LLC

  • Physical Therapist
  • Albuquerque, NM
  • NPI 1780695551
  Medicare reassignment Care Compare group NPD
• Athletico LTD

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Advanced Physical Therapy Services, LTD

  • Physical Therapist
  • Bloomington, IL
  • NPI 1437141504
  NPD (past)
• Advanced Physical Therapy Services, LTD

  • Physical Therapist
  • Galesburg, IL
  • NPI 1669119582
  NPD (past)

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

{
    "created_epoch": "1702512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1164290607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "fax_number": "309-661-8801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4730 ELMORE AVE STE 1",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073658",
            "telephone_number": "563-362-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRY",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-14",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070027759",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "122037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lake, D.C.
• Antoinette Lambert, AGNP
• Susan Lucille Lambert, D.C.
• Elizabeth Rose Lance
• Kristin Landram, PHARMD
• Isabelle Landwehr
• Nancy Erin Lange, LMSW
• Anne Marie Lansing, OTR
• Catherine Marie Lapage, DC
• Laparoscopic Surgical Specialties,LLC

• Physical Therapist in Davenport, IA
• Providers in Davenport, IA by specialty
• Physical Therapist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2025; 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.