Individual provider Active NPI

Kenneth George Jordan, MD

  • Neurology Physician
  • Redlands, CA
National Provider Identifier
1477537116
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
G283910 Issued in CA
Practice address
1980 Orange Tree LN Ste 230
Redlands, CA 92374-4559
Phone
(909) 881-1031
Fax
(909) 882-2891
NPI assigned
Dec 6, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X G283910 CA
Neurology Physician 2084N0400X G283910 CA Primary

Addresses

Primary practice location

1980 Orange Tree LN Ste 230
Redlands, CA 92374-4559

Mailing address

1980 Orange Tree LN Ste 230
Redlands, CA 92374-4559
Phone (909) 881-1031

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20070913000739 CA Practitioner - Neurology 1254425820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Columbia University College of Physicians and Surgeons, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1660 Plum LN
Redlands, CA 92374-4532
Phone (909) 881-1031

Hospital & facility affiliations

  • Bear Valley Community Hospital Hospital, Big Bear Lake, CA, CCN 051335

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

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

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Jordan Neuroservices a Medical Corporation Specialist CurrentSince Sep 13, 2007 Accepting new patients
Dignity Health Past Accepting new patients
Loma Linda University Medical Center Past Accepting new patients

Locations

1980 Orange Tree Ln
Ste 230
Redlands, CA 92374
Phone (909) 881-1031

1660 Plum Ln
Ste 115
Redlands, CA 92374

1660 Plum Ln
Redlands, CA 92374
Phone (909) 881-1031

399 E Highland Ave
Ste 316
Sn Bernrdno, CA 92404
Phone (714) 881-4506

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 3

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": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1477537116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1980 ORANGE TREE LN STE 230",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744559",
            "telephone_number": "909-881-1031",
            "fax_number": "909-882-2891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1980 ORANGE TREE LN STE 230",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923744559",
            "telephone_number": "909-881-1031",
            "fax_number": "909-882-2891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KENNETH",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "CA",
            "license": "G283910",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "G283910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redlands, CA

Sources for this page

Verify at the official NPI Registry.