Individual provider Active NPI

Jordan Noel Wiggins, CPNP-PC

  • Pediatric Nurse Practitioner
  • Houston, TX
National Provider Identifier
1598266991
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP144629 Issued in TX
Practice address
11970 Wilcrest Dr Ste 101
Houston, TX 77031-1923
Phone
(281) 933-8017
NPI assigned
Feb 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 850876 TX
Pediatric Nurse Practitioner 363LP0200X AP144629 TX Primary
Nurse Practitioner 363L00000X AP144629 TX

Addresses

Primary practice location

11970 Wilcrest Dr Ste 101
Houston, TX 77031-1923

Mailing address

11970 Wilcrest Dr Ste 101
Houston, TX 77031-1923
Phone (281) 933-8017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240221000099 TX Practitioner - Nurse Practitioner 3779927595 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
850876TXMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hermann Urgent Care PLLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

1505 E Winding Way Dr
Ste 112
Friendswood, TX 77546
Phone (281) 993-3860

2510 Smith Ranch Rd
Ste 102
Pearland, TX 77584
Phone (346) 439-7481

19419 Gulf Fwy
Ste 3
Webster, TX 77598
Phone (281) 316-0885

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AACHCD

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.

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1598266991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11970 WILCREST DR STE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770311923",
            "telephone_number": "281-933-8017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11970 WILCREST DR STE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770311923",
            "telephone_number": "281-933-8017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIGGINS",
        "first_name": "JORDAN",
        "middle_name": "NOEL",
        "credential": "CPNP-PC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TX",
            "license": "850876",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "AP144629",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP144629",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.