Active NPI
Samuel Jordan
- Physician Assistant
- Lexington, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 250 Hospital Dr
Lexington, NC 27292-6792 - Phone
- (336) 248-5161
- NPI assigned
- May 31, 2017
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
250 Hospital Dr
Lexington, NC 27292-6792
Mailing address
155 Rosedale Cir
Winston Salem, NC 27106-4637
Other practice location 1
250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 248-5161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
250 Hospital Dr
Lexington, NC 27292-6792
Phone (336) 716-2734
3120 Northline Ave
Greensboro, NC 27408-7814
Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wake Forest University Health Sciences | Current | Accepting new patients |
Locations
329 NC Highway 801 N
Bermuda Run, NC 27006
Phone (336) 716-8200
1240 Huffman Mill Rd
Burlington, NC 27215
Phone (336) 538-7000
250 Hospital Dr
Lexington, NC 27292
Phone (336) 238-4150
Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697
Interoperability endpoints
- sjordan2755493@carolinashealthcaresystem.direct-ci.com
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Winston Salem, NC
- NPI 1003803032
-
- Multi-Specialty Clinic/Center
- Statesville, NC
- NPI 1396216735
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Lexington, NC
- NPI 1417958331
-
- Psychiatric Hospital Unit
- Winston Salem, NC
- NPI 1063480531
-
- Rehabilitation Hospital Unit
- Winston Salem, NC
- NPI 1114995677
-
- General Acute Care Hospital
- Winston Salem, NC
- NPI 1144211301
-
- Clinical Medical Laboratory
- Winston Salem, NC
- NPI 1609162098
Hospital
-
- Pediatric Adolescent Medicine Physician
- Winston Salem, NC
- NPI 1912179219
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1496188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1447788716",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 ROSEDALE CIR",
"city": "WINSTON SALEM",
"state": "NC",
"postal_code": "271064637"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 HOSPITAL DR",
"city": "LEXINGTON",
"state": "NC",
"postal_code": "272926792",
"telephone_number": "336-248-5161"
}
],
"practiceLocations": [
{
"address_1": "250 Hospital Dr",
"address_purpose": "LOCATION",
"city": "Lexington",
"state": "NC",
"postal_code": "272926792",
"country_code": "US",
"telephone_number": "336-248-5161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JORDAN",
"first_name": "SAMUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-05-31",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.