Active NPI
Jody Lea Jordan, MD
- Specialist
- Albuquerque, NM
National Provider Identifier
1518014794
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 2006-0632
- Practice address
- 1001 Coal Ave SE
Albuquerque, NM 87106-5205 - Phone
- (505) 938-5858
- Fax
- (505) 938-5861
- NPI assigned
- Jan 3, 2007
- Last updated
- Jul 16, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 2006-0632 | NM | Primary |
Addresses
Primary practice location
1001 Coal Ave SE
Albuquerque, NM 87106-5205
Mailing address
1001 Coal Ave SE
Albuquerque, NM 87106-5205
Phone (505) 938-5858
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 54654823 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006-0632 | NM | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The University of Texas Health Science Center at San Antonio | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba UT Health San Antonio Multispecialty & Research Hospital
- General Acute Care Hospital
- San Antonio, TX
- NPI 1326829904
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1518014794",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1001 COAL AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871065205",
"telephone_number": "505-938-5858",
"fax_number": "505-938-5861"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 COAL AVE SE",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871065205",
"telephone_number": "505-938-5858",
"fax_number": "505-938-5861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "JODY",
"middle_name": "LEA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-03",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NM",
"license": "2006-0632",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "54654823",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.