Individual provider Active NPI

Jordan Wordekemper, DO

  • Anesthesiology Physician
  • Charleston, SC
National Provider Identifier
1356044473
Registry record updated Jun 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
LL89989 Issued in SC
Practice address
167 Ashley Ave
Charleston, SC 29425-9120
Phone
(843) 792-2322
NPI assigned
Mar 27, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X LL89989 SC Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

167 Ashley Ave
Charleston, SC 29425-9120

Mailing address

167 Ashley Ave
Charleston, SC 29425-9120
Phone (843) 792-2322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
LL89989SCMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1356044473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294259120",
            "telephone_number": "843-792-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294259120",
            "telephone_number": "843-792-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORDEKEMPER",
        "first_name": "JORDAN",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "SC",
            "license": "LL89989",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.