Active NPI
Jannetta Delois Jordan, PH.D.
- Professional Counselor
- Fayetteville, NC
National Provider Identifier
1578779336
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Jun 20, 2018.
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6537
- Practice address
- 2018 Hope Mills Rd
Fayetteville, NC 28304-4225 - Phone
- (910) 424-0972
- NPI assigned
- May 15, 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6537 | NC | Primary |
Addresses
Primary practice location
2018 Hope Mills Rd
Fayetteville, NC 28304-4225
Mailing address
1302 Saltwell PL
Fayetteville, NC 28314-6100
Phone (910) 213-4160
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)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578779336",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1302 SALTWELL PL",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283146100",
"telephone_number": "910-213-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2018 HOPE MILLS RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283044225",
"telephone_number": "910-424-0972"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "JANNETTA",
"middle_name": "DELOIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "6537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.