Parisa R Jordan, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

16085 Issued in NH

Practice address

2300 Southwood Dr
DHMC Department of Dermatology
Nashua, NH 03063-1818

Phone

(603) 577-4260

NPI assigned

Jul 1, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• Parisa Ravanfar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: pravanfar15863@direct.dartmouth-hitchcock.org

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

{
    "created_epoch": "1246406400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1467680280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SOUTHWOOD DR",
            "address_2": "DHMC DEPARTMENT OF DERMATOLOGY",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631818",
            "telephone_number": "603-577-4260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SOUTHWOOD DR",
            "address_2": "DHMC DEPARTMENT OF DERMATOLOGY",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631818",
            "telephone_number": "603-577-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "PARISA",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-01",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NH",
            "license": "LT 3245",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NH",
            "license": "16085",
            "primary": true
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "NH",
            "license": "16085",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3082136",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021347",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PARISA",
            "last_name": "RAVANFAR",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Erika Kimberly Jones, PHARM D
• Kristen Jones, BS
• Nora Jones, BA
• Tavia Jones, MA
• Veronica Morgan Jones, RPH, PHARMD
• Sean Michael Jordan, DPT, ATC, CSCS
• Nicole Jordon, BSW
• Douglas M Joseph, MD
• Christopher Joy, MS
• Kristina Joyal

• Dermatology Physician in Nashua, NH
• Providers in Nashua, NH by specialty
• Dermatology Physician in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2016; 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.