Individual provider Active NPI

Jordan Leigh Johnson

  • Certified Registered Nurse Anesthetist
  • Bel Air, MD
National Provider Identifier
1326708306
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
R219948 Issued in MD
Practice address
500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone
(443) 643-1000
NPI assigned
Dec 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X R219948 MD Primary

Addresses

Primary practice location

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324

Mailing address

3210 Meadow Valley Dr
Abingdon, MD 21009-2638
Phone (301) 481-9560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220715002090 MD Practitioner - Certified Registered Nurse Anesthetist (Crna) 6800277286 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Anesthesia and Pain Management Services PCGroup PAC ID 7719117530, 42 clinicians

Practice addresses (Care Compare)

500 Upper Chesapeake Dr
Bel Air, MD 21014-4324
Phone (443) 643-1000

Hospital & facility affiliations

  • Umd Upper Chesapeake Medical Center Hospital, Bel Air, MD, CCN 210049

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R219948MDMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Anesthesia & Pain Management Services, P.C. Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Maryland Anesthesia & Pain Management Services, PC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients

Locations

500 Upper Chesapeake Dr
Bel Air, MD 21014
Phone (443) 643-1000

5 N La Plata Ct
Ste 201
La Plata, MD 20646
Phone (301) 609-4000

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1639785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1326708306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 MEADOW VALLEY DR",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210092638",
            "telephone_number": "301-481-9560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UPPER CHESAPEAKE DR",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144324",
            "telephone_number": "443-643-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JORDAN",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-18",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MD",
            "license": "R219948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.