Jordan Minor, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2016-02108 Issued in NC

Practice address

100 N Pointe Blvd
Mount Airy, NC 27030-2266

Phone

(336) 789-6267

NPI assigned

Apr 11, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: jminor@direct.nrh.nchie.net
• Direct secure messaging: jminor@nmgpeds.gwaydirect.com

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1497198170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N POINTE BLVD",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302266",
            "telephone_number": "336-789-6267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N POINTE BLVD",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270302266",
            "telephone_number": "336-789-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINOR",
        "first_name": "JORDAN",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2016-02108",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "101260577",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roy Bruce Middleton, MD
• Diane Jane Milhan, PHD, DPT, DAOM
• Nicole Michelle Millard, PA-C
• Krysten Miller-Young, PTA
• Brandon Keith Mills, M.D.
• Challie A Minton, MD
• Husam Khaled Mohammad, RPH
• Amanda Fields Moncus
• Marissa Leigh Montgomery, FNP-C
• Edgar Mora, M.D.

• Pediatrics Physician in Mount Airy, NC
• Providers in Mount Airy, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2022; 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.