Ned C Jordan, RPA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

000809 Issued in NY

Practice address

107 Prospect St
Attica, NY 14011-1149

Phone

(585) 591-6000

Fax

(585) 591-6962

NPI assigned

Jun 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Attica Family Medicine, PLLC

  • Family Medicine Physician
  • Le Roy, NY
  • NPI 1679986681

  NY

  Medicare reassignment

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1467480293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9820 S STREET RD",
            "city": "LE ROY",
            "state": "NY",
            "postal_code": "144828815",
            "telephone_number": "585-768-2022",
            "fax_number": "585-591-6962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 PROSPECT ST",
            "city": "ATTICA",
            "state": "NY",
            "postal_code": "140111149",
            "telephone_number": "585-591-6000",
            "fax_number": "585-591-6962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "NED",
        "middle_name": "C",
        "credential": "RPA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NY",
            "license": "000809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "000809",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tara L Hay, LCSW-R
• Theresa Lee Houghton, PTA
• Necole Marie Hubbard, OTR/L
• Ninian Ikekwem
• Tricia Janes, LMSW
• Young Sung Jun, M.D.
• Julie Ann Kelsey, LPN
• Omar S Khokhar, MD
• Kosh Dentistry Attica
• Mariano Joseph Loverde Jr.

• All providers in Attica, NY
• Medical Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.