Active NPI
Christopher Jordan, APRN
- Family Nurse Practitioner
- Lake City, AR
National Provider Identifier
1306227434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- A004409
- Practice address
- 119 Cobean Blvd
Lake City, AR 72437-8884 - Phone
- (870) 819-7075
- NPI assigned
- Jun 15, 2015
- Sex
- Male
- 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 | A004409 | AR | Primary |
Addresses
Primary practice location
119 Cobean Blvd
Lake City, AR 72437-8884
Mailing address
1307 Ross Leighann LN
Lake City, AR 72437-8990
Phone (870) 819-7075
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A004409 | AR | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Pain Medicine | Past | Accepting new patients |
Organizations & group practices 1
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": "1434326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698105600000",
"number": "1306227434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1307 ROSS LEIGHANN LN",
"city": "LAKE CITY",
"state": "AR",
"postal_code": "724378990",
"telephone_number": "870-819-7075"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "119 COBEAN BLVD",
"city": "LAKE CITY",
"state": "AR",
"postal_code": "724378884",
"telephone_number": "870-819-7075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "CHRISTOPHER",
"credential": "APRN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-06-15",
"last_updated": "2023-10-24",
"certification_date": "2023-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "A004409",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lake City, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.