Jordan Gwinn

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

77196 Issued in WV

Practice address

327 Medical Park Dr
Bridgeport, WV 26330-9006

Phone

(304) 293-2436

NPI assigned

Mar 13, 2015

Sex

Male

Sole proprietor

No

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 WV

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

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Highland-Clarksburg Hospital

  • Psychiatric Hospital
  • Clarksburg, WV
  • NPI 1477990109
  NPD

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

{
    "created_epoch": "1426204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431043200000",
    "number": "1346633443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265070780",
            "telephone_number": "304-285-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 MEDICAL PARK DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309006",
            "telephone_number": "304-293-2436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GWINN",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-13",
        "last_updated": "2015-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "77196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adam Grubler, DDS
• Amber Guinup
• Cara Gump
• Jasmeen Kaur Guron
• Alexandra Nicole Guzzi
• Diana Lynn Hackett, CRNA
• Christopher Hagedorn, CRNA
• Juliet Haines, MOT
• Bethany Marie Hall, D.O.
• Lindsey Marie Hall, PA-C

• Family Nurse Practitioner in Bridgeport, WV
• Providers in Bridgeport, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.