Carllisa Roshea Jordan

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

5234 Red Hill Dr
Indian Head, MD 20640-3401

Phone

(301) 752-5852

NPI assigned

May 18, 2026

Last updated

May 18, 2026By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1779062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1386573251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5234 RED HILL DR",
            "city": "INDIAN HEAD",
            "state": "MD",
            "postal_code": "206403401",
            "telephone_number": "301-752-5852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5234 RED HILL DR",
            "city": "INDIAN HEAD",
            "state": "MD",
            "postal_code": "206403401",
            "telephone_number": "301-752-5852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CARLLISA",
        "middle_name": "ROSHEA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-05-18",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Indian Head Pharmacy Inc (Indian Head Care Pharmacy)
• Indian Head Volunteer Fire Dept and Rescue Squad, Inc.
• Channel James
• Surnita Lawon Jefferson-Jones
• Sherry Teresa Johnson
• Memuna Kamara, N.P.
• Grace W Kariuki, LCPC
• Kevin F Kelley Sr., PA-C
• Keyana Kelly
• Latortue Smiles

• Community Health Worker in Indian Head, MD
• Providers in Indian Head, MD by specialty
• Community Health Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2026; 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.