Active NPI
Jordan Barrett Nalls
- Surgical Physician Assistant
- Catonsville, MD
National Provider Identifier
1417892878
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- Practice address
- 910 Frederick Rd
Catonsville, MD 21228-4516 - Phone
- (410) 644-1880
- NPI assigned
- Apr 22, 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 |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | Primary |
Addresses
Primary practice location
910 Frederick Rd
Catonsville, MD 21228-4516
Mailing address
14530 Dorsey Mill Rd
Glenwood, MD 21738-9320
Phone (240) 394-2580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1776816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780531200000",
"number": "1417892878",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14530 DORSEY MILL RD",
"city": "GLENWOOD",
"state": "MD",
"postal_code": "217389320",
"telephone_number": "240-394-2580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "910 FREDERICK RD",
"city": "CATONSVILLE",
"state": "MD",
"postal_code": "212284516",
"telephone_number": "410-644-1880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NALLS",
"first_name": "JORDAN",
"middle_name": "BARRETT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2026-04-22",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Catonsville, MD
- Yvette Lyn Myers, L.AC.
- Myeyedr Optometry of Maryland, LLC
- Myorthos Maryland Orthodontics - Labbe PC
- Elaine Kay Nahai
- Hiroshi Nakazawa, MD
- Shobha Nandivada, RD
- Matthew Joshua Narrett, MD
- Basem Samir Nashed, DMD
- Nasseri Clinic of Arthritic & Rheumatic Diseases LLC
- Nasseri Clinic of Arthritic & Rheumatic Diseases LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.