Active NPI
Tawan Jordan
- Driver
- Slidell, LA
National Provider Identifier
1245718550
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- Practice address
- 750 E I 10 Service Rd Ste G
Slidell, LA 70461-5535 - Phone
- (504) 228-7853
- Fax
- (504) 326-6513
- NPI assigned
- Jul 30, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | LA | Primary |
Addresses
Primary practice location
750 E I 10 Service Rd Ste G
Slidell, LA 70461-5535
Mailing address
1008 McCartney CT
Slidell, LA 70461-4844
Phone (504) 228-7836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Selfmade Transportation Service, LLC | Past | Accepting new patients |
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.
-
- Non-emergency Medical Transport (VAN)
- Slidell, LA
- NPI 1225511850
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532908800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1532908800000",
"number": "1245718550",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 MCCARTNEY CT",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704614844",
"telephone_number": "504-228-7836",
"fax_number": "985-326-6513"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 E I 10 SERVICE RD STE G",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704615535",
"telephone_number": "504-228-7853",
"fax_number": "504-326-6513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "TAWAN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-30",
"last_updated": "2018-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "LA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.