Individual provider Active NPI

James William Jordan, M.D.

  • Neurology Physician
  • Everett, WA
National Provider Identifier
1417156993
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD60251434 Issued in WA
Practice address
1321 Colby Ave FL 3
Everett, WA 98201-1665
Phone
(425) 261-2000
Fax
(425) 261-4078
NPI assigned
Jul 13, 2007
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 57.008958 OH
Neurology Physician 2084N0400X MD60251434 WA Primary

Addresses

Primary practice location

1321 Colby Ave FL 3
Everett, WA 98201-1665

Mailing address

PO Box 5127
Everett, WA 98206-5127

Other practice location 1

747 Broadway # Ww-A11B
Seattle, WA 98122-4379
Phone (206) 320-3417

Other identifiers 2

IdentifierTypeStateIssuer
2801463MedicaidOH
2015739MedicaidWA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jjordan125080@wm.providencedirect.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120329000427 WA Practitioner - Neurology 3870675002 Reassigns benefits to 11 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians
Providence Medical InstituteGroup PAC ID 5991609737, 303 clinicians
Providence Health and Services MtGroup PAC ID 6608786306, 358 clinicians

Practice addresses (Care Compare)

Everett, WA 98203
Phone (206) 386-6787

1707 Edgemoor LN
Everett, WA 98203-1663

413 Lilly Rd NE
Olympia, WA 98506-5133

7320 216TH St SW
Edmonds, WA 98026-8006

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
57.008958OHMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services- Washington CurrentSince Jul 17, 2021 Accepting new patients
Providence Health & Services Oregon Current Accepting new patients
Providence Health & Services- Washington CurrentSince Dec 1, 2017 Accepting new patients
Providence Health & Services Washington CurrentSince Jul 29, 2021 Accepting new patients
Providence Health & Services Washington CurrentSince Jul 17, 2021 Accepting new patients
Optum Care Washington PLLC CurrentSince Feb 4, 2012 Accepting new patients
Providence Health & Services Mt CurrentSince Jun 12, 2021 Accepting new patients
Providence Medical Institute CurrentSince Aug 4, 2021 Accepting new patients
Providence Health & Services-Wa Current Accepting new patients
Swedish Health Services CurrentSince Jun 29, 2015 Accepting new patients
Providence Health & Services-Washington CurrentSince Mar 1, 2015 Accepting new patients
Swedish Health Services CurrentSince Jun 29, 2015 Accepting new patients
Providence Health & Services - Washington CurrentSince Dec 1, 2017 Accepting new patients
Providence Health & Services Oregon CurrentSince Jun 12, 2021 Accepting new patients
Providence Medical Institute CurrentSince Aug 4, 2021 Accepting new patients
Providence Health & Services - Washington CurrentSince Jul 17, 2021 Accepting new patients
Optum Care Washington PLLC CurrentSince Feb 4, 2012 Accepting new patients
Providence Health & Services - Washington CurrentSince Jul 17, 2021 Accepting new patients
Providence Health & Services - Oregon CurrentSince Jun 12, 2021 Accepting new patients

Locations

7320 216th St SW
Ste 310
Edmonds, WA 98026
Phone (425) 673-3800

1321 Colby Ave
Everett, WA 98201
Phone (425) 259-4413

1321 Colby Ave
Fl 3
Everett, WA 98201

1330 Rockefeller Ave
Everett, WA 98201
Phone (425) 258-3903

900 Pacific Ave
Fl 5
Everett, WA 98201
Phone (425) 258-7311

4112 Harbour Pointe Blvd SW
Ste 100
Mukilteo, WA 98275
Phone (425) 347-6330

413 Lilly Rd NE
Olympia, WA 98506
Phone (360) 491-9480

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

747 Broadway
Seattle, WA 98122
Phone (360) 658-2488

747 Broadway
#11B
Seattle, WA 98122
Phone (206) 317-1956

800 5th Ave
Ste 600
Seattle, WA 98104

380 Chase Ave
Walla Walla, WA 99362
Phone (509) 526-3333

Organizations & group practices 19

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.

View all 19

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1417156993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 COLBY AVE FL 3",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982011665",
            "telephone_number": "425-261-2000",
            "fax_number": "425-261-4078"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "747 Broadway # Ww-A11B",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981224379",
            "country_code": "US",
            "telephone_number": "206-320-3417",
            "fax_number": "206-320-7195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JAMES",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "OH",
            "license": "57.008958",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD60251434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2801463",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2015739",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jjordan125080@wm.providencedirect.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "747 Broadway # Ww-A11B",
            "city": "Seattle",
            "state": "WA",
            "country_code": "US",
            "postal_code": "981224379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

Verify at the official NPI Registry.