Individual provider Active NPI

Arianna Yoshiko Jordan, OD

  • Optometrist
  • Baltimore, MD
National Provider Identifier
1437790813
Registry record updated Sep 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
TA2847 Issued in MD
Practice address
1042 Patapsco St
Baltimore, MD 21230-4595
Phone
(800) 485-9196
Fax
(213) 402-5261
NPI assigned
Oct 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X TA2847 MD Primary

Addresses

Primary practice location

1042 Patapsco St
Baltimore, MD 21230-4595

Mailing address

12100 Wilshire Blvd Ste 1275
Los Angeles, CA 90025-7143
Phone (800) 485-9196

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

LicenseStateTypeSpecialty
TA2847MDMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Stacy Coen, LLC Optometrist PastSince Oct 1, 2019 Accepting new patients
Vision to Learn Optometrist PastSince Mar 1, 2022 Accepting new patients
Vision to Learn Optometrist PastSince Sep 25, 2022 Accepting new patients

Organizations & group practices 3

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": "1570406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1437790813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12100 WILSHIRE BLVD STE 1275",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900257143",
            "telephone_number": "800-485-9196",
            "fax_number": "213-402-5261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1042 PATAPSCO ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304595",
            "telephone_number": "800-485-9196",
            "fax_number": "213-402-5261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ARIANNA",
        "middle_name": "YOSHIKO",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-07",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.