Individual provider Active NPI

Jordan Andrew Coleman, CRNA

  • Certified Registered Nurse Anesthetist
  • Lexington, SC
National Provider Identifier
1477056281
Registry record updated Apr 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
21973 Issued in SC
Practice address
130 May Morning Dr
Lexington, SC 29073-9440
Phone
(803) 608-8034
NPI assigned
Mar 18, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 217780 SC
Certified Registered Nurse Anesthetist 367500000X 1477056281 SC
Certified Registered Nurse Anesthetist 367500000X 21973 SC Primary

Addresses

Primary practice location

130 May Morning Dr
Lexington, SC 29073-9440

Mailing address

130 May Morning Dr
Lexington, SC 29073-9440
Phone (803) 608-8034

Other practice location 1

7 Independence Pt Ste 300
Greenville, SC 29615-4569
Phone (864) 522-3700

Other identifiers 1

IdentifierTypeStateIssuer
AN2775MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181018001248 SC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0941552038 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Musc Community PhysiciansGroup PAC ID 6507260668, 1,353 clinicians

Practice addresses (Care Compare)

506 N St
Bamberg, SC 29003-1319
Phone (803) 245-6290

805 Pamplico Hwy
Florence, SC 29505-6047

Hospital & facility affiliations

  • Musc Health Florence Medical Center Hospital, Florence, SC, CCN 420091

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
217780SCMDRegistered Nurse
1477056281SCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jun 19, 2023 Accepting new patients
Prisma Health University Medical Group Current Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Medstream Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 22, 2021 Accepting new patients
Trident Anesthesia Group, LLC CurrentSince Sep 1, 2024 Accepting new patients
Musc Community Physicians CurrentSince Aug 1, 2021 Accepting new patients
Musc Community Physicians Current Accepting new patients
Atlantic Coast Anesthesia Services P.C. Nurse Anesthetist, Certified Registered CurrentSince May 24, 2018 Accepting new patients
Prisma Health University Medical Group CurrentSince Jun 19, 2023 Accepting new patients
Beach Anesthesia, LLC CurrentSince Jan 11, 2022 Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

109 Blarney Dr
Columbia, SC 29223
Phone (803) 865-8200

7 Independence Pt
Ste 300
Greenville, SC 29615
Phone (864) 522-3700

67 Creekside Park Ct
Greenville, SC 29615
Phone (864) 242-4602

423 Barony St
Moncks Corner, SC 29461

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

1021 Cipriana Dr
Ste 100
Myrtle Beach, SC 29572
Phone (843) 449-7885

2669 Kinard St
Newberry, SC 29108
Phone (803) 276-7570

9330 Medical Plaza Dr
North Charleston, SC 29406
Phone (843) 554-6366

9313 Medical Plaza Dr
Ste 102
North Charleston, SC 29406
Phone (843) 572-1228

3000 Saint Matthews Rd
Orangeburg, SC 29118
Phone (803) 395-2200

295 Midland Pkwy
Summerville, SC 29485
Phone (843) 554-6366

Organizations & group practices 10

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": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681948800000",
    "number": "1477056281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 MAY MORNING DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290739440",
            "telephone_number": "803-608-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 MAY MORNING DR",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290739440",
            "telephone_number": "803-608-8034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Independence Pt Ste 300",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296154569",
            "country_code": "US",
            "telephone_number": "864-522-3700",
            "fax_number": "864-522-3705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COLEMAN",
        "first_name": "JORDAN",
        "middle_name": "ANDREW",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-18",
        "last_updated": "2023-04-20",
        "certification_date": "2023-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "SC",
            "license": "217780",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "1477056281",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "SC",
            "license": "21973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "AN2775",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.