Individual provider Active NPI

Karen Elizabeth Jordan, APRN-CNP

  • Family Nurse Practitioner
  • Shreveport, LA
National Provider Identifier
1285265397
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
211569 Issued in LA
Practice address
172 Southfield Rd
Shreveport, LA 71105-3721
Phone
(318) 464-1755
NPI assigned
Jan 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 211569 LA Primary

Addresses

Primary practice location

172 Southfield Rd
Shreveport, LA 71105-3721

Mailing address

172 Southfield Rd
Shreveport, LA 71105-3721
Phone (318) 464-1755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200401000056 LA Practitioner - Nurse Practitioner 9032548722 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
WK Urgent Care Center-PierremontGroup PAC ID 8123016946, 39 clinicians

Practice addresses (Care Compare)

1666 E Bert Kouns Industrial Loop
Suite 105
Shreveport, LA 71105-5718
Phone (318) 212-3520

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
211569LAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
WK Urgent Care Center-Pierremont CurrentSince Apr 27, 2021 Accepting new patients
WK Advanced Surgery Center Past Accepting new patients

Locations

5751 Shed Rd
Ste 100
Bossier City, LA 71111
Phone (318) 935-1900

2600 Greenwood Rd
Shreveport, LA 71103
Phone (318) 212-4600

1666 E Bert Kouns Industrial Loop
Ste 105
Shreveport, LA 71105
Phone (318) 212-3520

1202 Louisiana Ave
Shreveport, LA 71101
Phone (318) 212-8946

Organizations & group practices 2

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": "1580169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1285265397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 SOUTHFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053721",
            "telephone_number": "318-464-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 SOUTHFIELD RD",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711053721",
            "telephone_number": "318-464-1755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KAREN",
        "middle_name": "ELIZABETH",
        "credential": "APRN-CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "211569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.