Marlon D Jordan, MD
Individual provider Active NPI Cardiovascular Disease Physician · Mount Carmel, IL
NPI 1467415117 · NPPES record last updated Feb 17, 2022
Key facts
- NPI
- 1467415117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 036082355 (IL)
- Practice address
- 1418 College Dr
Mount Carmel, IL 62863-2638 - Phone
- (618) 240-2740
- Fax
- (618) 263-6479
- NPI assigned
- Apr 11, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 64.72 of 100
- Quality
- 65.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 10
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110118001307 | IL | Practitioner - Cardiovascular Disease (Cardiology) | 7214840404 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036082355 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ferrell Hospital Community Foundation | Current | Accepting new patients | |
| The Heart Hospital at Deaconess Gateway, LLC | Past | Accepting new patients |
Locations
1201 Pine St
Eldorado, IL 62930
Phone (618) 273-3361
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 01030224A | IN | |
| Cardiovascular Disease Physician | 207RC0000X | 036082355 | IL | Yes |
Addresses
Primary practice location
1418 College Dr
Mount Carmel, IL 62863-2638
Mailing address
1418 College Dr
Mount Carmel, IL 62863-2638
Phone (618) 240-2740
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000042524 | Other | ANTHEM | |
| 64756620 | Medicaid | KY | |
| 100343920A | Medicaid | IN |
Other providers in Mount Carmel, IL
- James B O'Neal, Ms Amd Associates, PC
- Siddharth B Jani
- Lawrence P Jennings
- Kaitlyn Ann Johnson
- Kathleen Johnson
- Srinath Kamineni
- Lori Beth Kasinger
- Audra Keepes
- John Logan Keepes
- Candace Keen Kemper
All providers in Mount Carmel, IL · Cardiovascular Disease Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.