Individual provider Active NPI

Teneisha Shavaugh Jordan, MD

  • Family Medicine Physician
  • Aiken, SC
National Provider Identifier
1558857045
Registry record updated May 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
95139 Issued in SC
Practice address
410 University Parkeay
1550A
Aiken, SC 29801
Phone
(803) 306-7733
NPI assigned
Jul 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 95139 SC Primary
Family Medicine Physician 207Q00000X 84336 GA

Addresses

Primary practice location

410 University Parkeay
1550A
Aiken, SC 29801

Mailing address

P.O. Box 2162
Grovetown, GA 30813-0310
Phone (713) 551-6523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20250919000042 SC Practitioner - Family Practice 1153721287 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Morehouse School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

137 Miracle Dr
Aiken, SC 29801-6351
Phone (803) 226-0589

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
95139SCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aiken Professional Association LLC Family Medicine CurrentSince Sep 22, 2025 Accepting new patients
Aiken Professional Association, LLC Family Medicine CurrentSince Sep 22, 2025 Accepting new patients

Locations

410 University Pkwy
Ste 1150A
Aiken, SC 29801

410 University Pkwy
Ste 1550A
Aiken, SC 29801
Phone (803) 306-7733

137 Miracle Dr
Aiken, SC 29801
Phone (803) 226-0589

Organizations & group practices 2

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1531008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778112000000",
    "number": "1558857045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 2162",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "308130310",
            "telephone_number": "713-551-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 UNIVERSITY PARKEAY",
            "address_2": "1550A",
            "city": "AIKEN",
            "state": "SC",
            "postal_code": "29801",
            "telephone_number": "803-306-7733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TENEISHA",
        "middle_name": "SHAVAUGH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-08",
        "last_updated": "2026-05-07",
        "certification_date": "2026-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "95139",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "84336",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiken, SC

Sources for this page

Verify at the official NPI Registry.