Jordan Allen, CRNP, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

SP018302 Issued in PA

Practice address

1526 Lombard St
Philadelphia, PA 19146-1625

Phone

(215) 546-5960

NPI assigned

Jan 3, 2018

Sex

Female

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 MD

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

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tidalhealth Specialty Care LLCGroup PAC ID 7113340845, 375 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

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 and National Provider Directory roles.

• Tidalhealth Specialty Care, LLC

  • Medical Specialty Clinic/Center
  • Salisbury, MD
  • NPI 1619504735
  Medicare reassignment Care Compare group NPD
• Privia Care Center LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1164874426

  MD

  Medicare reassignment NPD
• Privia Medical Group, LLC

  • Internal Medicine Physician
  • Arlington, VA
  • NPI 1013042480

  MD

  Medicare reassignment NPD
• Menocal Medical Services PA

  • Family Medicine Physician
  • Frederick, MD
  • NPI 1083795918
  NPD
• Privia Care Center LLC

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1730664012
  NPD
• Privia Medical Group, LLC

  • Pain Medicine (Psychiatry & Neurology) Physician
  • Rockville, MD
  • NPI 1811715436
  NPD
• Tidalhealth Specialty Care, LLC

  • Adult Mental Health Clinic/Center
  • Salisbury, MD
  • NPI 1962027094
  NPD (past)

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1407363153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1705 LOWER MILLSTONE LN",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 LOMBARD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461625",
            "telephone_number": "215-546-5960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALLEN",
        "first_name": "JORDAN",
        "credential": "CRNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP018302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Miles Allen, MD, MS
• Frederick Thomas Allen, MD
• Herbert B Allen, M.D.
• James G. Allen, D.O.
• Jeong L Allen, CRNA
• Julian L Allen, M.D.
• Kathryn Allen
• Kayla Allen
• Keesha Yvonne Allen
• Lekiesha Sophia Allen

• Nurse Practitioner in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.