Individual provider Active NPI

Katherine Jordan, M.D.

  • Pediatrics Physician
  • Cary, NC
National Provider Identifier
1265842637
Registry record updated May 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2017-00416 Issued in NC
Practice address
6715 McCrimmon Pkwy Ste 300
Cary, NC 27519-1916
Phone
(919) 481-4997
Fax
(919) 388-3271
NPI assigned
May 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 201369 NC
Pediatrics Physician 208000000X 2017-00416 NC Primary

Addresses

Primary practice location

6715 McCrimmon Pkwy Ste 300
Cary, NC 27519-1916

Mailing address

Unc Dept of Pediatrics
260 Macnider Building, CB# 7220
Chapel Hill, NC 27599-7220
Phone (919) 966-1505

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kjordan32048@direct.UNC.nchie.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170829002441 NC Practitioner - Pediatric Medicine 6406071026 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2017-00416NCMDPediatrics Physician
201369NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Unc Physicians Network LLC Current Accepting new patients
University of North Carolina at Chapel Hill Pediatrics CurrentSince Jun 27, 2017 Accepting new patients
Unc Physicians Network LLC Pediatrics CurrentSince Jan 5, 2020 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation Pediatrics CurrentSince Apr 11, 2018 Accepting new patients
The Moses H Cone Memorial Hospital Operating Corporation CurrentSince Apr 11, 2018 Accepting new patients
University of North Carolina Hospitals at Chapel Hill Past Accepting new patients

Locations

6715 McCrimmon Pkwy
Ste 300
Cary, NC 27519
Phone (919) 481-4997

940 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 942-5123

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

6013 Farrington Rd
Ste 301
Chapel Hill, NC 27517
Phone (984) 974-4191

1200 N Elm St
Greensboro, NC 27401
Phone (336) 574-7000

2000 Perimeter Park Dr
Ste 200
Morrisville, NC 27560
Phone (800) 594-8624

Organizations & group practices 6

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": "1399334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620604800000",
    "number": "1265842637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "UNC DEPT OF PEDIATRICS",
            "address_2": "260 MACNIDER BUILDING, CB# 7220",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997220",
            "telephone_number": "919-966-1505",
            "fax_number": "919-966-7299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6715 MCCRIMMON PKWY STE 300",
            "city": "CARY",
            "state": "NC",
            "postal_code": "275191916",
            "telephone_number": "919-481-4997",
            "fax_number": "919-388-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KATHERINE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-05-06",
        "last_updated": "2021-05-10",
        "certification_date": "2021-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "201369",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2017-00416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kjordan32048@direct.UNC.nchie.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "6715 McCrimmon Pkwy Ste 300",
            "city": "Cary",
            "state": "NC",
            "country_code": "US",
            "postal_code": "275191916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cary, NC

Sources for this page

Verify at the official NPI Registry.