Candace N Jordan, MS, OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OTR2296 Issued in AR

Practice address

250 University Dr
Monticello, AR 71655-8891

Phone

(870) 367-6893

NPI assigned

Jul 23, 2013

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Occupational Therapy Services Inc.

  • Pediatric Occupational Therapist
  • Lake Village, AR
  • NPI 1942314893
  NPD (past)

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

{
    "created_epoch": "1374537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655164800000",
    "number": "1275975971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 BURTON RD",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716559657",
            "telephone_number": "870-723-9873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 UNIVERSITY DR",
            "city": "MONTICELLO",
            "state": "AR",
            "postal_code": "716558891",
            "telephone_number": "870-367-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CANDACE",
        "middle_name": "N",
        "credential": "MS, OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-23",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AR",
            "license": "OTR2296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NBCOT",
            "identifier": "257815",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaitlyn Johnson
• Kassandra Jones
• Lynda Allison Jones, PTA
• Misty Dawn Jones, LPN
• Andrea Jordan, QBHP
• David B Jordan, MHPP
• Tincy Jordan, OT
• Joseph P. Miles, DDS, PA
• Helen Regina Junior
• Stacy Elizabeth Justice, PT

• All providers in Monticello, AR
• Occupational Therapist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.