Jenny Marie Jordan, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

006339 Issued in GA

Practice address

103 Maple Dr
Augusta, GA 30907-4283

Phone

(706) 364-5262

NPI assigned

Aug 10, 2009

Sex

Female

Sole proprietor

Yes

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 GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Maguire Therapy Services Inc.

  • Physical Therapy Clinic/Center
  • Augusta, GA
  • NPI 1407174535
  Medicare reassignment NPD
• Ducktails Pediatric Therapy and Wellness Inc

  • Physical Therapy Clinic/Center
  • Evans, GA
  • NPI 1558477695
  NPD (past)

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

{
    "created_epoch": "1249862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1255563243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MAPLE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309074283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MAPLE DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309074283",
            "telephone_number": "706-364-5262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JENNY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-10",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "006339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Jopling Jr.
• Nicholas Mawuena Joppa, MD
• Tracey Michelle Jordan-Richardson
• Benjamin Jordan, PA
• Jaqwan Jordan
• Rafael Eduardo Jordan, M.D.
• Shara Jordan, BSW
• Sharon C. Jordan
• Shikara S Jordan
• Vann Fraylick Jordan, DPT

• Speech-Language Pathologist in Augusta, GA
• Providers in Augusta, GA by specialty
• Speech-Language Pathologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.