Individual provider Active NPI

Jordan Reid Mudd

  • Occupational Health Registered Nurse
  • Glendale, KY
National Provider Identifier
1356210926
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Health Registered NurseTaxonomy code 163WX0106X
License
1141347 Issued in KY
Practice address
2022 Battery Park Dr
Glendale, KY 42740-8800
Phone
(859) 314-3670
NPI assigned
Nov 3, 2025
Last updated
Nov 7, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Health Registered Nurse 163WX0106X 1141347 KY Primary

Addresses

Primary practice location

2022 Battery Park Dr
Glendale, KY 42740-8800

Mailing address

2910 Shrewsbury Rd
Leitchfield, KY 42754-8227

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1141347KYMDOccupational Health Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1356210926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2910 SHREWSBURY RD",
            "city": "LEITCHFIELD",
            "state": "KY",
            "postal_code": "427548227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2022 BATTERY PARK DR",
            "city": "GLENDALE",
            "state": "KY",
            "postal_code": "427408800",
            "telephone_number": "859-314-3670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUDD",
        "first_name": "JORDAN",
        "middle_name": "REID",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WX0106X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Occupational Health",
            "state": "KY",
            "license": "1141347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.