Individual provider Active NPI

Iza Nadine Jordan, DO

  • Neuromusculoskeletal Medicine & OMM Physician
  • Orlando, FL
National Provider Identifier
1225599202
Registry record updated Jun 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X
License
OS18020 Issued in FL
Practice address
5540 E Grant St Ste B
Orlando, FL 32822-1668
Phone
(407) 747-1222
NPI assigned
Mar 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuromusculoskeletal Medicine & OMM Physician 204D00000X OS18020 FL Primary

Addresses

Primary practice location

5540 E Grant St Ste B
Orlando, FL 32822-1668

Mailing address

4409 Hoffner Ave # 412
Orlando, FL 32812-2331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20220629003894 FL Practitioner - Osteopathic Manipulative Medicine 0547640047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Osteopathic Manipulative Medicine
Education
Philadelphia College of Osteopathic Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians
Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians
Brett Thomas DO, PAGroup PAC ID 8921399940, 2 clinicians

Practice addresses (Care Compare)

1200 Lexington Green LN
Sanford, FL 32771-1013

5540 E Grant St
Suite B
Orlando, FL 32822-1668
Phone (407) 747-1222

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Brett Thomas DO PA Neuromusculoskeletal Medicine & Omm CurrentSince Jul 23, 2022 Accepting new patients

Locations

4409 Hoffner Ave
Orlando, FL 32812
Phone (407) 353-0887

1160 S Semoran Blvd
Ste C
Orlando, FL 32807
Phone (407) 250-5001

5540 E Grant St
Ste B
Orlando, FL 32822
Phone (407) 747-1222

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1225599202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 HOFFNER AVE # 412",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328122331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 E GRANT ST STE B",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328221668",
            "telephone_number": "407-747-1222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "IZA",
        "middle_name": "NADINE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-30",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "FL",
            "license": "OS18020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.