Active NPI
David W Jordan, MD
- Internal Medicine Physician
- Helena, MT
National Provider Identifier
1386633378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 4325
- Practice address
- 1 Medical Park Dr
Helena, MT 59601-8022 - Phone
- (406) 443-3457
- Fax
- (406) 443-7201
- NPI assigned
- Oct 21, 2005
- Last updated
- Jul 21, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 4325 | MT | Primary |
Addresses
Primary practice location
1 Medical Park Dr
Helena, MT 59601-8022
Mailing address
1 Medical Park Dr
Helena, MT 59601-8022
Phone (406) 443-3457
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000012340 | Other | MT | BLUE CROSS BLUE SHIELD |
| 9989778 | Other | MT | MEDICAID PASSPORT |
| 055094 | Medicaid | MT | |
| P00089863 | Other | PALMETTO GBA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Critical Access Hospital
- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248134400000",
"number": "1386633378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 MEDICAL PARK DR",
"city": "HELENA",
"state": "MT",
"postal_code": "596018022",
"telephone_number": "406-443-3457",
"fax_number": "406-443-7201"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 MEDICAL PARK DR",
"city": "HELENA",
"state": "MT",
"postal_code": "596018022",
"telephone_number": "406-443-3457",
"fax_number": "406-443-7201"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "DAVID",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2009-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MT",
"license": "4325",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "0000012340",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID PASSPORT",
"identifier": "9989778",
"state": "MT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "055094",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTO GBA",
"identifier": "P00089863",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Helena, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.