Active NPI
Jamie L Jordan, APN
- Family Nurse Practitioner
- Paragould, AR
National Provider Identifier
1285726869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A02927
- Practice address
- 630 W Court St
Paragould, AR 72450-4247 - Phone
- (870) 236-6911
- Fax
- (870) 236-8129
- NPI assigned
- Sep 29, 2006
- Last updated
- May 13, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | A02927 | AR | Primary |
Addresses
Primary practice location
630 W Court St
Paragould, AR 72450-4247
Mailing address
630 W Court St
Paragould, AR 72450-4247
Phone (870) 236-6911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 177311758 | Medicaid | AR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A02927 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harris Family Medicine, PLLC | Current | Accepting new patients | |
| JPC Medical Inc | Past | Accepting new patients |
Locations
630 W Court St
#B
Paragould, AR 72450
Phone (870) 236-6911
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GDABAA/Endpoint/GDABAA
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Paragould, AR
- NPI 1710530480
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463097600000",
"number": "1285726869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 W COURT ST",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724504247",
"telephone_number": "870-236-6911",
"fax_number": "870-236-8129"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 W COURT ST",
"city": "PARAGOULD",
"state": "AR",
"postal_code": "724504247",
"telephone_number": "870-236-6911",
"fax_number": "870-236-8129"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "JAMIE",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "APN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2016-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A02927",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "177311758",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Paragould, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.