Active NPI
Danette Jordan, MD, MPH
- Family Medicine Physician
- Philadelphia, PA
National Provider Identifier
1487989844
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD446787
- Practice address
- 8815 Germantown Ave
5TH Floor Family Practice
Philadelphia, PA 19118-2722 - Phone
- (215) 248-8145
- Fax
- (215) 248-8852
- NPI assigned
- Oct 2, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MT195141 | PA | |
| Family Medicine Physician | 207Q00000X | 2013-02418 | NC | |
| Family Medicine Physician | 207Q00000X | 53726 | CT | |
| Family Medicine Physician | 207Q00000X | MD446787 | PA | Primary |
Addresses
Primary practice location
8815 Germantown Ave
5TH Floor Family Practice
Philadelphia, PA 19118-2722
Mailing address
1241 E. Dyer Rd,
Suite 145
Santa Ana, CA 92705
Phone (949) 449-1112
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53726 | CT | MD | Family Medicine Physician |
| 2013-02418 | NC | MD | Family Medicine Physician |
| MT195141 | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1254441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495497600000",
"number": "1487989844",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1241 E. DYER RD,",
"address_2": "SUITE 145",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "92705",
"telephone_number": "949-449-1112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8815 GERMANTOWN AVE",
"address_2": "5TH FLOOR FAMILY PRACTICE",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191182722",
"telephone_number": "215-248-8145",
"fax_number": "215-248-8852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "DANETTE",
"name_prefix": "Dr.",
"credential": "MD, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-02",
"last_updated": "2017-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MT195141",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "2013-02418",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CT",
"license": "53726",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD446787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.