Carl Daniel Jordan, DO

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

P1774 Issued in TX

Practice address

101 Crown Pointe Blvd
Willow Park, TX 76087-1191

Phone

(817) 757-1675

Fax

(817) 757-1676

NPI assigned

Jun 25, 2007

Last updated

Jan 9, 2020By the provider in NPPES

Sex

Male

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

• C Daniel Jordan Professional name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Texas Health Physicians GroupGroup PAC ID 4385535954, 1,364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hospital Southwest F Hospital, Fort Worth, TX, CCN 450779
• Texas Health Harris Methodist Hospital Azle Hospital, Azle, TX, CCN 450419
• Texas Health Harris Methodist Fort Worth Hospital, Fort Worth, TX, CCN 450135

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cjordan1385638@direct.texashealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Texas Health Physicians Group

  • Internal Medicine Physician
  • Fort Worth, TX
  • NPI 1174573596
  Medicare reassignment Care Compare group NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Fort Worth, TX
  • NPI 1114395969
  NPD
• Texas Health Physicians Group

  dba Sleep Healers

  • Sleep Disorder Diagnostic Clinic/Center
  • Dallas, TX
  • NPI 1174992051
  NPD

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

• Texas Health Harris Methodist Hospital Azle

  • General Acute Care Hospital
  • Azle, TX
  • NPI 1508899204
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1336172105
  Care Compare affiliation
• Texas Health Harris Methodist Hospital Southwest Fort Worth

  • General Acute Care Hospital
  • Fort Worth, TX
  • NPI 1417980202
  Care Compare affiliation

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1194921452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 CROWN POINTE BLVD",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760871191",
            "telephone_number": "817-757-1675",
            "fax_number": "817-757-1676"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CROWN POINTE BLVD",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "760871191",
            "telephone_number": "817-757-1675",
            "fax_number": "817-757-1676"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CARL",
        "middle_name": "DANIEL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-25",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "P1774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "C",
            "last_name": "JORDAN",
            "middle_name": "DANIEL",
            "credential": "DO",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mar'Kyiden James
• Andrew Michael Jen, M.D.
• Benjamin Johnson, MS, LPC
• Darla Leigh Johnson
• Whitney Beanette Jones, CPM, LM
• Keith Marshall Kahil, PT, DPT
• Erika Karaganis
• Karen Kennedy Home Care LLC (FirstLight Home Care of West Fort Worth & Parker County)
• Melissa Keane
• Tonya Monice Keith El, DR

• Surgery Physician in Willow Park, TX
• Providers in Willow Park, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2020; 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.