William Travis Jordan, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004861 Issued in VA

Practice address

4037 Taylor Rd Ste C
Chesapeake, VA 23321-5500

Phone

(757) 609-3677

Fax

(757) 299-4214

NPI assigned

Oct 24, 2013

Last updated

Jul 21, 2022By 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

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Colonial Internal Medicine Associates PCGroup PAC ID 6608842521, 18 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Colonial Internal Medicine Associates PC

  • Internal Medicine Physician
  • Fredericksburg, VA
  • NPI 1346260940
  Medicare reassignment Care Compare group NPD
• Behavioral Health Navigators Inc.

  • Clinical Psychologist
  • Chesapeake, VA
  • NPI 1356745673
  Authorized official Same address or phone

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

{
    "created_epoch": "1382572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245668516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 TAYLOR RD STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215500",
            "telephone_number": "757-609-3677",
            "fax_number": "757-299-4214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4037 TAYLOR RD STE C",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233215500",
            "telephone_number": "757-609-3677",
            "fax_number": "757-299-4214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 N Main St",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234344422",
            "country_code": "US",
            "telephone_number": "757-609-3677",
            "fax_number": "757-299-4214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2050 Hillpoint Blvd N",
            "address_purpose": "LOCATION",
            "city": "Suffolk",
            "state": "VA",
            "postal_code": "234347181",
            "country_code": "US",
            "telephone_number": "757-983-8650",
            "fax_number": "757-299-4214",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "638 Independence Pkwy Ste 240",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233205222",
            "country_code": "US",
            "telephone_number": "757-609-3677",
            "fax_number": "757-299-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "WILLIAM",
        "middle_name": "TRAVIS",
        "name_prefix": "Dr.",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-24",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris Jordan, BCBA, LBA
• Jessica Ann Jordan, DNP, CPNP-PC
• Khadijah Yasin Jordan, M.D.
• Mary Ellen Jordan
• Tiwana Lynn Jordan
• Joyful Hearts LLC
• Joyful Living Home Care, LLC
• Joyful Ride Transportation LLC
• Joyful Transportation, LLC
• Ashleigh Joyner

• Clinical Psychologist in Chesapeake, VA
• Providers in Chesapeake, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.