Active NPI
Jordan Bumgardner
- Registered Nurse
- Boiling Springs, NC
National Provider Identifier
1407704174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 345114
- Practice address
- 110 S Main St
Boiling Springs, NC 28017-9797 - Phone
- (704) 406-4000
- NPI assigned
- Mar 18, 2026
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 345114 | NC | Primary |
Addresses
Primary practice location
110 S Main St
Boiling Springs, NC 28017-9797
Mailing address
240 Tryon School Loop Rd
Bessemer City, NC 28016-7612
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 345114 | NC | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1773792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773792000000",
"number": "1407704174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "240 TRYON SCHOOL LOOP RD",
"city": "BESSEMER CITY",
"state": "NC",
"postal_code": "280167612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 S MAIN ST",
"city": "BOILING SPRINGS",
"state": "NC",
"postal_code": "280179797",
"telephone_number": "704-406-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUMGARDNER",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-03-18",
"last_updated": "2026-03-18",
"certification_date": "2026-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NC",
"license": "345114",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boiling Springs, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.