NPIMap

Individual provider Active NPI

Candise Elaine Jordan, FNP-BC

  • Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1326345042
Registry record updated May 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
2011003425 Issued in MO
Practice address
3850 S National Ave
Suite 600
Springfield, MO 65807-5287
Phone
(417) 882-4880
Fax
(417) 882-7843
NPI assigned
Feb 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2011003425 MO
Nurse Practitioner 363L00000X 2011003425 MO Primary

Addresses

Primary practice location

3850 S National Ave
Suite 600
Springfield, MO 65807-5287

Mailing address

9160 Forum Corporate Pkwy Ste 350
Fort Myers, FL 33905-7808
Phone (239) 785-3200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110308000117 MO Practitioner - Nurse Practitioner 1254513518 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Oncology Partners PAGroup PAC ID 0042569758, 377 clinicians

Practice addresses (Care Compare)

802 E Hwy 60
Monett, MO 65708-9311
Phone (417) 882-4880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
American Oncology Partners PA Nurse Practitioner CurrentSince Nov 1, 2019 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

9160 Forum Corporate Pkwy
Ste 350
Fort Myers, FL 33905
Phone (239) 785-3200

802 E Highway 60
Monett, MO 65708
Phone (417) 882-4880

3850 S National Ave
Ste 600
Springfield, MO 65807
Phone (417) 882-4880

Interoperability endpoints

  • Direct secure messaging: candise.jordan@cernerdirect.coxhealth.com

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.

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1297728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1326345042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9160 FORUM CORPORATE PKWY STE 350",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339057808",
            "telephone_number": "239-785-3200",
            "fax_number": "813-630-6105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 S NATIONAL AVE",
            "address_2": "SUITE 600",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075287",
            "telephone_number": "417-882-4880",
            "fax_number": "417-882-7843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CANDISE",
        "middle_name": "ELAINE",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-15",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2011003425",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2011003425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.