Khadijah Yasin Jordan, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

0101052592 Issued in VA

Practice address

111 Medical Pkwy
Suite 202
Chesapeake, VA 23320-0302

Phone

(757) 436-2424

Fax

(757) 436-6628

NPI assigned

Apr 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: khadijah.jordan@va011.digichart.direct-ci.com

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.

• Demc, Inc

  • Women's Hospital
  • Chesapeake, VA
  • NPI 1770765612
  NPD (past)
• Margie Corney, MD PC

  • Obstetrics & Gynecology Physician
  • Chesapeake, VA
  • NPI 1104973270

  Obstetrics & Gynecology

  NPD (past)

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

{
    "created_epoch": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1528022688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 MEDICAL PKWY",
            "address_2": "SUITE 202",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200302",
            "telephone_number": "757-436-2424",
            "fax_number": "757-436-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MEDICAL PKWY",
            "address_2": "SUITE 202",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233200302",
            "telephone_number": "757-436-2424",
            "fax_number": "757-436-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KHADIJAH",
        "middle_name": "YASIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-14",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101052592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10202531",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Trey Jones
• Jordan Transportation LLC
• Antwan L Jordan, D.C.
• Chris Jordan, BCBA, LBA
• Jessica Ann Jordan, DNP, CPNP-PC
• Mary Ellen Jordan
• Tiwana Lynn Jordan
• William Travis Jordan, LCP
• Joyful Hearts LLC
• Joyful Living Home Care, LLC

• All providers in Chesapeake, VA
• Obstetrics & Gynecology Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.