Individual provider Active NPI

Jordan Nicole Kesler, APRN

  • Primary Care Nurse Practitioner
  • Bridgeport, WV
National Provider Identifier
1407460918
Registry record updated Sep 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
106937 Issued in WV
Practice address
527 Medical Park Dr Ste 501
Bridgeport, WV 26330-9010
Phone
(304) 842-3993
NPI assigned
Sep 2, 2020
Last updated
Sep 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 106937 WV Primary

Addresses

Primary practice location

527 Medical Park Dr Ste 501
Bridgeport, WV 26330-9010

Mailing address

29 Overlook Dr
Bridgeport, WV 26330-1021
Phone (304) 516-3642

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20201221002070 WV Practitioner - Nurse Practitioner 8224440938 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Vascular and Vein Center PLLCGroup PAC ID 7416271556, 5 clinicians

Practice addresses (Care Compare)

527 Medical Park Dr
Suite 501
Bridgeport, WV 26330-9010
Phone (304) 842-3993

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
106937WVMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
United Vascular & Vein Center PLLC CurrentSince Oct 9, 2020 Accepting new patients

Locations

527 Medical Park Dr
Ste 501
Bridgeport, WV 26330
Phone (304) 842-3993

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.

Hospital & facility affiliations 2

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": "1599004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599004800000",
    "number": "1407460918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 OVERLOOK DR",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263301021",
            "telephone_number": "304-516-3642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR STE 501",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309010",
            "telephone_number": "304-842-3993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KESLER",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-02",
        "last_updated": "2020-09-02",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WV",
            "license": "106937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.