Individual provider Active NPI

Jordan Cohen

  • Emergency Medicine Physician
  • Fort Defiance, AZ
National Provider Identifier
1558749309
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD2022-0143 Issued in NM
Practice address
Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649
Phone
(928) 729-8600
NPI assigned
May 13, 2015
Last updated
Aug 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD2022-0143 NM Primary
Emergency Medicine Physician 207P00000X LPO3292 RI

Addresses

Primary practice location

Corner of Route N12 and N7
Fort Defiance, AZ 86504-0649

Mailing address

PO Box 649
Fort Defiance, AZ 86504-0649
Phone (928) 729-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, NM2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190920002011 TX Practitioner - Emergency Medicine 4688904485 Reassigns benefits to 1 organization
I20250707002264 NM Practitioner - Emergency Medicine 4688904485

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Vanderbilt University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Corner of Route N12 and N7
Fdihb Inc.
Fort Defiance, AZ 86504-0649
Phone (928) 729-8082

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LPO3292RIMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Fort Defiance Indian Hospital Board, Incorporation CurrentSince Sep 16, 2019 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: jcohen584394@christushealth.direct-ci.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1431475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1558749309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 649",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CORNER OF ROUTE N12 AND N7",
            "city": "FORT DEFIANCE",
            "state": "AZ",
            "postal_code": "865040649",
            "telephone_number": "928-729-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHEN",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-13",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NM",
            "license": "MD2022-0143",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "LPO3292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Defiance, AZ

Sources for this page

Verify at the official NPI Registry.