Mary Jordan, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

R125380-1 Issued in MN

Practice address

2001 Bloomington Avenue S
Community-University Health Care Center
Minneapolis, MN 55404-3074

Phone

(612) 638-0700

NPI assigned

Aug 3, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Certified Nurse Practitioner, Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Hennepin County

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1780790345
  Medicare reassignment NPD
• Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1215951751
  NPD
• Hennepin County

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1962147413
  NPD
• Hennepin County

  • Student Health Clinic/Center
  • Minneapolis, MN
  • NPI 1205145448
  NPD (past)

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477561991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 BLOOMINGTON AVENUE S",
            "address_2": "COMMUNITY-UNIVERSITY HEALTH CARE CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043074",
            "telephone_number": "612-638-0700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 BLOOMINGTON AVENUE S",
            "address_2": "COMMUNITY-UNIVERSITY HEALTH CARE CENTER",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554043074",
            "telephone_number": "612-638-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MARY",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MN",
            "license": "R125380-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chantel Alexus Jordan
• Editha Tingas Jordan, MSN
• Farhio Mohamud Jordan
• Julia Jordan, PSY.D., L.P.
• Leah Michele Krause Jordan, MD
• Matt Jordan
• Michael Andrew Jordan, M.D.
• Zane Jorgens, RN
• Bryce Jorgensen, DO
• Diane Marie Jorgensen, LICSW

• Pediatric Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Pediatric Nurse Practitioner in Minnesota

• 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.