Active NPI
Jordan Schenck, NP
- Family Nurse Practitioner
- Branford, CT
National Provider Identifier
1558728204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 340266
- Practice address
- 1204 Main St Ste 576
Branford, CT 06405-3787 - Phone
- (844) 359-8363
- NPI assigned
- Jan 26, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 12.11367 | CT | |
| Family Nurse Practitioner | 363LF0000X | 5021604 | NC | |
| Family Nurse Practitioner | 363LF0000X | 4015702 | KY | |
| Family Nurse Practitioner | 363LF0000X | 209034324 | IL | |
| Family Nurse Practitioner | 363LF0000X | 234834 | LA | |
| Family Nurse Practitioner | 363LF0000X | 879913 | NV | |
| Family Nurse Practitioner | 363LF0000X | 226317 | AR | |
| Family Nurse Practitioner | 363LF0000X | RN2372521 | MA | |
| Family Nurse Practitioner | 363LF0000X | NP500018659 | DC | |
| Family Nurse Practitioner | 363LF0000X | 4704410421 | MI | |
| Family Nurse Practitioner | 363LF0000X | APRN-4582 | HI | |
| Family Nurse Practitioner | 363LF0000X | 340266 | NY | Primary |
| Family Nurse Practitioner | 363LF0000X | 215989 | AK | |
| Family Nurse Practitioner | 363LF0000X | 95029529 | CA |
Addresses
Primary practice location
1204 Main St Ste 576
Branford, CT 06405-3787
Mailing address
1 Eisenhower Dr
East Quogue, NY 11942-4726
Phone (631) 793-0041
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
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southampton Hospital Association | Past | Accepting new patients |
Interoperability endpoints
- jordan.foster.1@17222.direct.athenahealth.com
- jordan.foster.1@20088.direct.athenahealth.com
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 and National Provider Directory roles.
-
dba Westhampton Primary Care Center
- Primary Care Clinic/Center
- Westhampton Beach, NY
- NPI 1295899086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1453766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789516800000",
"number": "1558728204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 EISENHOWER DR",
"city": "EAST QUOGUE",
"state": "NY",
"postal_code": "119424726",
"telephone_number": "631-793-0041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1204 MAIN ST STE 576",
"city": "BRANFORD",
"state": "CT",
"postal_code": "064053787",
"telephone_number": "844-359-8363"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHENCK",
"first_name": "JORDAN",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-26",
"last_updated": "2026-09-16",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "12.11367",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NC",
"license": "5021604",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "KY",
"license": "4015702",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "IL",
"license": "209034324",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "LA",
"license": "234834",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NV",
"license": "879913",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AR",
"license": "226317",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "RN2372521",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "DC",
"license": "NP500018659",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704410421",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "HI",
"license": "APRN-4582",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "NY",
"license": "340266",
"primary": true
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "AK",
"license": "215989",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95029529",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Branford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.