Individual provider Active NPI

Naitte P. Jordan, FNP

  • Nurse Practitioner
  • Los Banos, CA
National Provider Identifier
1346223757
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
NPF4199 Issued in CA
Practice address
400 W I St
Los Banos, CA 93635-3459
Phone
(209) 826-0195
Fax
(209) 827-0554
NPI assigned
Nov 21, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NPF4199 CA Primary

Addresses

Primary practice location

400 W I St
Los Banos, CA 93635-3459

Mailing address

400 W I St
Los Banos, CA 93635-3459
Phone (209) 826-0195

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20041006000847 CA Practitioner - Nurse Practitioner 8123087087 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NPF4199CAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Valleys Health Centers CurrentSince Mar 2, 2020 Accepting new patients
Central California Bariatric Surgery, Partnership CurrentSince Dec 1, 2024 Accepting new patients
Mountain Valleys Health Centers Current Accepting new patients
Mountain Valleys Health Centers CurrentSince Mar 2, 2020 Accepting new patients

Locations

610 W 3rd St
Dorris, CA 96023
Phone (530) 397-8411

1001 Sylvan Ave
Ste A
Modesto, CA 95350
Phone (209) 248-7168

1552 Coffee Rd
Ste 200
Modesto, CA 95355
Phone (209) 248-7168

Interoperability endpoints

  • Direct secure messaging: naitte.jordan.1@33563.direct.athenahealth.com
  • Direct secure messaging: naitte.jordan.p1@direct.cdsdp.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1346223757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353459",
            "telephone_number": "209-826-0195",
            "fax_number": "209-827-0554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W I ST",
            "city": "LOS BANOS",
            "state": "CA",
            "postal_code": "936353459",
            "telephone_number": "209-826-0195",
            "fax_number": "209-827-0554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "NAITTE",
        "middle_name": "P.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "NPF4199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Banos, CA

Sources for this page

Verify at the official NPI Registry.