Individual provider Active NPI

Jordan A Nash, MD

  • Pediatrics Physician
  • Scott Depot, WV
National Provider Identifier
1437384161
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
24824 Issued in WV
Practice address
111 Great Teays Blvd
Scott Depot, WV 25560-9548
Phone
(304) 757-8459
Fax
(304) 757-6904
NPI assigned
May 26, 2009
Last updated
Nov 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 24824 WV Primary

Addresses

Primary practice location

111 Great Teays Blvd
Scott Depot, WV 25560-9548

Mailing address

PO Box 1680
Huntington, WV 25717
Phone (304) 697-1396

Other identifiers 3

IdentifierTypeStateIssuer
7100239930MedicaidWV
0075746MedicaidOH
3810023601MedicaidWV

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120822000816 WV Practitioner - Pediatric Medicine 2365699568 Reassigns benefits to 4 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems Inc Pediatrics CurrentSince Jan 1, 2016 Accepting new patients
Valley Health Systems Inc CurrentSince Jul 1, 2012 Accepting new patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems, Inc. CurrentSince Oct 20, 2014 Accepting new patients
Valley Health Systems, Inc. Pediatrics CurrentSince Oct 18, 2019 Accepting new patients
Valley Health Systems Inc Current Accepting new patients
Valley Health Systems Inc Past Accepting new patients

Locations

2585 3rd Ave
Huntington, WV 25703
Phone (304) 697-1396

3729 Teays Valley Rd
Ste 100
Hurricane, WV 25526
Phone (304) 760-6040

220 Johns Creek Rd
Milton, WV 25541
Phone (304) 743-1407

111 Great Teays Blvd
Scott Depot, WV 25560
Phone (304) 757-1907

Interoperability endpoints

  • Direct secure messaging: jnash20145@valleyhealthsystems.direct-ci.com

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1243296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1437384161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1680",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "25717",
            "telephone_number": "304-697-1396",
            "fax_number": "304-297-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GREAT TEAYS BLVD",
            "city": "SCOTT DEPOT",
            "state": "WV",
            "postal_code": "255609548",
            "telephone_number": "304-757-8459",
            "fax_number": "304-757-6904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NASH",
        "first_name": "JORDAN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-26",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "24824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100239930",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0075746",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810023601",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scott Depot, WV

Sources for this page

Verify at the official NPI Registry.