Terry Mark Jordan, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-108733 Issued in AL

Practice address

2700 Hospital Dr
Northport, AL 35476-3360

Phone

(205) 333-4565

NPI assigned

Jun 4, 2019

Last updated

Jun 4, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Relias Emergency Medicine Specialists of Northport, LLC

  • Emergency Medicine Physician
  • Northport, AL
  • NPI 1699261149
  Medicare reassignment NPD
• Relias Emergency Medicine Specialists of Regional, LLC

  • Emergency Medicine Physician
  • Tuscaloosa, AL
  • NPI 1619463163
  Medicare reassignment NPD

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

{
    "created_epoch": "1559606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559606400000",
    "number": "1396303244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9308 TAYLORWOOD DR",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354055937",
            "telephone_number": "205-349-5501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 HOSPITAL DR",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354763360",
            "telephone_number": "205-333-4565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TERRY",
        "middle_name": "MARK",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-04",
        "last_updated": "2019-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-108733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Lee Jones, PHARMD
• Moyacca Jones, ALC
• Richard Edwin Jones III, MD
• Michael Christopher Jordan, LAT ATC
• Tacarra Simone Jordan
• Joshua Tree Counseling & Wellness, LLC
• K&B Medical Supply LLC
• Sakina A Kamal, M.D.
• Toheed J. Kamal, M.D.
• Kamal. K. Raisani, M.D. P.C.

• Family Nurse Practitioner in Northport, AL
• Providers in Northport, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.