Jordan Leigh Thackston, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN287787 Issued in GA

Practice address

24 Amherst Dr
Winder, GA 30680-7463

Phone

(470) 900-4368

NPI assigned

Dec 28, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jordan Leigh Evans Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Nurse Practitioner

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta Allergy and Asthma Clinic PAGroup PAC ID 1254372006, 42 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HJBFBA

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.

• Atlanta Allergy & Asthma Clinic PA

  • Allergy & Immunology Physician
  • Atlanta, GA
  • NPI 1598796195
  Medicare reassignment Care Compare group NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  GA

  Medicare reassignment NPD
• Medlife Healthcare LLC

  • Family Medicine Physician
  • Flowery Branch, GA
  • NPI 1558974709
  NPD (past)
• Medlife Urgent Care LLC

  • Urgent Care Clinic/Center
  • McDonough, GA
  • NPI 1083249114
  NPD (past)

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

{
    "created_epoch": "1735344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1194533711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 AMHERST DR",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306807463",
            "telephone_number": "470-900-4368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 AMHERST DR",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306807463",
            "telephone_number": "470-900-4368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2129 Friendship Rd",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305192600",
            "country_code": "US",
            "telephone_number": "770-209-2787",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4038 Winder Hwy",
            "address_purpose": "LOCATION",
            "city": "Flowery Branch",
            "state": "GA",
            "postal_code": "305423021",
            "country_code": "US",
            "telephone_number": "678-693-2364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THACKSTON",
        "first_name": "JORDAN",
        "middle_name": "LEIGH",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-28",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN287787",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "EVANS",
            "middle_name": "LEIGH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Stephaine Tabb
• Altaf Husain Tadkod, M.D., M.P.H.
• Brendalyne Facia Tamba, FNP
• Poppy M Tansey, NP
• Sharon Lyle Taylor, M.D.
• Xue Thao, PHARM.D.
• The Abundant Life Institute Inc
• The Genesis Center of Winder LLC
• The Grounding Space Counseling and Consulting, LLC
• The Healthy Home Barrow LLC

• Family Nurse Practitioner in Winder, GA
• Providers in Winder, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.