Individual provider Active NPI

Charlton F Jordan, M.D.

  • Anesthesiology Physician
  • Rockingham, VA
National Provider Identifier
1366732240
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
0101257654 Issued in VA
Practice address
2010 Health Campus Dr
Rockingham, VA 22801-8679
Phone
(540) 689-1000
NPI assigned
Apr 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101257654 VA Primary

Addresses

Primary practice location

2010 Health Campus Dr
Rockingham, VA 22801-8679

Mailing address

2010 Health Campus Dr
Rockingham, VA 22801-8679
Phone (405) 689-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150608001763 VA Practitioner - Anesthesiology 1759519689 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Jefferson Medical College of Thomas Jefferson University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SMG Anesthesia Specialists LLCGroup PAC ID 6305081118, 501 clinicians

Practice addresses (Care Compare)

2010 Health Campus Dr
Rockingham, VA 22801-8679
Phone (434) 654-5000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456-0178
Phone (757) 507-1000

Hospital & facility affiliations

  • Sentara RMH Medical Center Hospital, Harrisonburg, VA, CCN 490004

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101257654VAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SMG Anesthesia Specialists LLC Anesthesiology CurrentSince Oct 1, 2020 Accepting new patients

Locations

2010 Health Campus Dr
Rockingham, VA 22801
Phone (540) 689-1000

3920A Bridge Rd
Suffolk, VA 23435
Phone (757) 983-0000

2025 Glenn Mitchell Dr
Virginia Beach, VA 23456
Phone (757) 507-1000

Organizations & group practices 1

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 1

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": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1366732240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 HEALTH CAMPUS DR",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018679",
            "telephone_number": "405-689-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 HEALTH CAMPUS DR",
            "city": "ROCKINGHAM",
            "state": "VA",
            "postal_code": "228018679",
            "telephone_number": "540-689-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CHARLTON",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-13",
        "last_updated": "2023-12-01",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101257654",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockingham, VA

Sources for this page

Verify at the official NPI Registry.