Jeremy Dugger Jordan, CRNP, CPNP-AC

Primary specialty

Critical Care Pediatric Nurse PractitionerTaxonomy code 363LP0222X

License

1-135633 Issued in AL

Practice address

1600 7TH Ave S
Cppi 102
Birmingham, AL 35233-1711

Phone

(205) 638-3400

NPI assigned

Feb 5, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jjordan20637@childrensofalabama.direct-ci.com

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512950400000",
    "number": "1417348905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1720 2ND AVE S # NB308",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352941210",
            "telephone_number": "205-996-3651",
            "fax_number": "205-996-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 7TH AVE S",
            "address_2": "CPPI 102",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331711",
            "telephone_number": "205-638-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JEREMY",
        "middle_name": "DUGGER",
        "credential": "CRNP, CPNP-AC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-05",
        "last_updated": "2017-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-136533",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "AL",
            "license": "1-136533",
            "primary": false
        },
        {
            "code": "363LP0222X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics, Critical Care",
            "state": "AL",
            "license": "1-135633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jayasree Jonnadula, MD
• Bryan Jordan
• Dimari Maurice Jordan
• Jacqueline D Jordan, CO
• Jamesse S Jordan, LMSW
• Josh Jordan, PHARMD
• Katherine Cross Jordan, MS, RDN, LDN
• Keiasha Marie Jordan, CRNP
• Melissa Rae Jordan, MD
• Scott Jordan, PT

• Critical Care Pediatric Nurse Practitioner in Birmingham, AL
• Providers in Birmingham, AL by specialty
• Critical Care Pediatric Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.