NPIMap

Individual provider Active NPI

Jordan Martha Lee Fenner

  • Diagnostic Radiology Physician
  • Chapel Hill, NC
National Provider Identifier
1356831622
Registry record updated Nov 24, 2025
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Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
84156 Issued in WI
Practice address
101 Manning Dr
Chapel Hill, NC 27514-4220
Phone
(984) 974-1000
NPI assigned
May 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 2020-03182 NC
Diagnostic Radiology Physician 2085R0202X 84156 WI Primary

Addresses

Primary practice location

101 Manning Dr
Chapel Hill, NC 27514-4220

Mailing address

4833 Crystal Downs Way
Middleton, WI 53597-8960
Phone (630) 400-7662

Other practice location 1

3623 Latrobe Dr Ste 216
Charlotte, NC 28211-2117
Phone (704) 332-1291

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240726003164 WI Practitioner - Diagnostic Radiology 9537414461 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health Cooperative of South Central WisconsinGroup PAC ID 3870489586, 233 clinicians
Mecklenburg Radiology Associates PAGroup PAC ID 6800789587, 95 clinicians

Practice addresses (Care Compare)

3051 Cahill Main
Fitchburg, WI 53711-7109
Phone (608) 661-7200

4833 Crystal Downs Way
Middleton, WI 53597-8960
Phone (704) 332-1291

8202 Excelsior Dr
Madison, WI 53717-1906
Phone (608) 831-1766

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.21 of 100Reported as group
Quality
71.09
Promoting interoperability
99
Improvement activities
40
Cost
70.44

Merit-based Incentive Payment System (MIPS)

Final score
83.32 of 100Reported as group
Quality
87.78
Promoting interoperability
77
Improvement activities
40
Cost
75.8

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2020-03182NCMDDiagnostic Radiology Physician
84156WIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mecklenburg Radiology Associates, P.a. Diagnostic Radiology CurrentSince Dec 1, 2025 Accepting new patients
Group Health Cooperative of South Central Wisconsin CurrentSince Sep 3, 2024 Accepting new patients

Locations

3623 Latrobe Dr
Ste 216
Charlotte, NC 28211
Phone (704) 926-1827

600 Highland Ave
Madison, WI 53792
Phone (608) 263-0325

8202 Excelsior Dr
Madison, WI 53717
Phone (608) 831-1766

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 8

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": "1526083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1356831622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4833 CRYSTAL DOWNS WAY",
            "city": "MIDDLETON",
            "state": "WI",
            "postal_code": "535978960",
            "telephone_number": "630-400-7662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MANNING DR",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275144220",
            "telephone_number": "984-974-1000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3623 Latrobe Dr Ste 216",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282112117",
            "country_code": "US",
            "telephone_number": "704-332-1291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FENNER",
        "first_name": "JORDAN",
        "middle_name": "MARTHA LEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-12",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2020-03182",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WI",
            "license": "84156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chapel Hill, NC

Sources for this page

Verify at the official NPI Registry.