Individual provider Active NPI

Blair Philip Jordan, MD

  • Surgery Physician
  • Conroe, TX
National Provider Identifier
1457448490
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
F8180 Issued in TX
Practice address
508 Medical Center Blvd
Ste 200
Conroe, TX 77304-2953
Phone
(936) 760-4600
Fax
(936) 760-4601
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X F8180 TX Primary

Addresses

Primary practice location

508 Medical Center Blvd
Ste 200
Conroe, TX 77304-2953

Mailing address

508 Medical Center Blvd
Ste 200
Conroe, TX 77304-2953
Phone (936) 760-4600

Other identifiers 1

IdentifierTypeStateIssuer
098632501MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address BLAIR.JORDAN@hca9.eclinicaldirectplus.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101227000263 TX Practitioner - General SurgeryPractitioner - Vascular Surgery 3072701671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Vascular Surgery
Education
University of Connecticut School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conroe Montgomery Physicians Group, PLLCGroup PAC ID 1850547365, 14 clinicians

Practice addresses (Care Compare)

504 Medical Ctr Blvd
Conroe, TX 77304-2808
Phone (936) 539-7415

508 Medical Ctr Blvd
Suite 150
Conroe, TX 77304-2845
Phone (836) 760-4600

Hospital & facility affiliations

  • HCA Houston Healthcare Conroe Hospital, Conroe, TX, CCN 450222

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Melanoma (skin cancer) excision1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Conroe Montgomery Physicians Group, PLLC CurrentSince Jul 1, 2012 Accepting new patients
Sadler Clinic Association Past Accepting new patients

Locations

508 Medical Center Blvd
Ste 200
Conroe, TX 77304
Phone (936) 760-4600

508 Medical Center Blvd
Ste 150
Conroe, TX 77304
Phone (836) 760-4600

Interoperability endpoints

  • Direct secure messaging: blair.jordan@hca9.eclinicaldirectplus.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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1457448490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 MEDICAL CENTER BLVD",
            "address_2": "STE 200",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042953",
            "telephone_number": "936-760-4600",
            "fax_number": "936-760-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "508 MEDICAL CENTER BLVD",
            "address_2": "STE 200",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773042953",
            "telephone_number": "936-760-4600",
            "fax_number": "936-760-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "BLAIR",
        "middle_name": "PHILIP",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "F8180",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "098632501",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "BLAIR.JORDAN@hca9.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "508 Medical Center Blvd",
            "address_2": "STE 200",
            "city": "Conroe",
            "state": "TX",
            "country_code": "US",
            "postal_code": "773042953",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Conroe, TX

Sources for this page

Verify at the official NPI Registry.