Individual provider Active NPI

Jordan Elise Wood, NP

  • Family Nurse Practitioner
  • Logansport, IN
National Provider Identifier
1396598629
Registry record updated Apr 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71015103A Issued in IN
Practice address
1201 Michigan Ave
Logansport, IN 46947-1580
Phone
(415) 157-4753
NPI assigned
Apr 8, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71015103A IN Primary

Addresses

Primary practice location

1201 Michigan Ave
Logansport, IN 46947-1580

Mailing address

1201 Michigan Ave
Logansport, IN 46947-1580
Phone (415) 157-4753

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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

Enrollment IDStateProvider typePAC IDDetails
I20240528000205 IN Practitioner - Nurse Practitioner 2062854755 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Parkview Logansport Hospital IncGroup PAC ID 8921500646, 41 clinicians
Memorial HospitalGroup PAC ID 8123923281, 64 clinicians

Practice addresses (Care Compare)

1025 Michigan Ave
Suite 115
Logansport, IN 46947-1665
Phone (574) 722-3566

1201 Michigan Ave
Suite 330
Logansport, IN 46947-1570
Phone (574) 753-4151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Parkview Logansport Hospital, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Parkview Logansport Hospital, Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

1201 Michigan Ave
Ste 270
Logansport, IN 46947
Phone (574) 722-4921

1101 Michigan Ave
Logansport, IN 46947
Phone (574) 753-1475

1201 Michigan Ave
Ste 330
Logansport, IN 46947
Phone (574) 753-4151

1025 Michigan Ave
Ste 115
Logansport, IN 46947
Phone (574) 722-3566

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 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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1396598629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471580",
            "telephone_number": "415-157-4753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MICHIGAN AVE",
            "city": "LOGANSPORT",
            "state": "IN",
            "postal_code": "469471580",
            "telephone_number": "415-157-4753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOD",
        "first_name": "JORDAN",
        "middle_name": "ELISE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-04-08",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71015103A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logansport, IN

Sources for this page

Verify at the official NPI Registry.