Charles Raymond Jordan, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R869908 Issued in MS

Practice address

1350 Sunset Dr Ste B
Grenada, MS 38901-4079

Phone

(662) 466-3632

NPI assigned

Aug 24, 2011

Sex

Male

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 MS

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

Specialty

Nurse Practitioner

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wound Management Specialists LLCGroup PAC ID 5193056364, 157 clinicians

Rapid Track Urgent Care, LLCGroup PAC ID 8820431943, 9 clinicians

Healthcare Plus Limited Liability CompanyGroup PAC ID 5698038610, 120 clinicians

Fast Pace Mississippi PLLCGroup PAC ID 3678832029, shared by 4 NPIs, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Accentcare Home Health of Greenwood Home health agency, Greenwood, MS, CCN 257131
• Greenwood Leflore Hospital Hospital, Greenwood, MS, CCN 250099
• Panola Medical Center Hospital, Batesville, MS, CCN 250781

Merit-based Incentive Payment System (MIPS)

Final score

92.62 of 100Reported as apm

Quality

88.22

Promoting interoperability

77

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Rapid Track Urgent Care LLC

  • Urgent Care Clinic/Center
  • Grenada, MS
  • NPI 1003529652
  Medicare reassignment Care Compare group NPD
• Wound Management Specialists, LLC

  • Nurse Practitioner
  • Flowood, MS
  • NPI 1972150084
  Medicare reassignment Care Compare group NPD
• Healthcare Plus Limited Liability Company

  • Specialist
  • Metairie, LA
  • NPI 1063927465

  MS

  Medicare reassignment Care Compare group NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment NPD
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Medicare reassignment NPD
• Dermaccel

  • Clinic/Center
  • Trussville, AL
  • NPI 1992582241

  Family, MS

  Medicare reassignment NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Hoover, AL
  • NPI 1538686498

  MS

  Medicare reassignment NPD
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Greenwood Leflore Hospital

  • Emergency Medicine Physician
  • Greenwood, MS
  • NPI 1861670911
  NPD
• Upperline Healthcare, PC

  • Foot & Ankle Surgery Podiatrist
  • Ocoee, FL
  • NPI 1326906843
  NPD
• Delta Radiology PLLC

  • Vascular & Interventional Radiology Physician
  • Cleveland, MS
  • NPI 1194048231
  NPD (past)
• Delta Wound Care PLLC

  • Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
  • Cleveland, MS
  • NPI 1235404377
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Sta-Home Health Agency of Greenwood, Inc.

  • Home Health Agency
  • Greenwood, MS
  • NPI 1235270588
  Care Compare affiliation
• State of Mississippi - University of Mississippi Medical Center

  • General Acute Care Hospital
  • Greenwood, MS
  • NPI 1699714717
  Care Compare affiliation
• Strategic Solutions-Panola Medical Center LLC

  • Rural Acute Care Hospital
  • Batesville, MS
  • NPI 1053873307
  Care Compare affiliation

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

{
    "created_epoch": "1314144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314144000000",
    "number": "1306126263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 395",
            "city": "N.CARROLLTON",
            "state": "MS",
            "postal_code": "389470395",
            "telephone_number": "662-466-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 SUNSET DR STE B",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014079",
            "telephone_number": "662-466-3632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CHARLES",
        "middle_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-24",
        "last_updated": "2011-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R869908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James W. Fite, MD
• John a Marascalco, MD, PA
• John H. Coleman,PLLC
• Nekesha Micole Johnson, FNP-BC
• Luanne Fair Pender Jones, PHARM. D.
• Joseph F Roberts MD PA
• Joseph S Messina Jr MD
• Alwin Max Juchheim III, DPM
• JWM Therapy Services
• K Squared, Inc.

• Family Nurse Practitioner in Grenada, MS
• Providers in Grenada, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.