Individual provider Active NPI

Keri Nicole Jordan, R.N., N.N.P.

  • Registered Nurse
  • Sunrise, FL
National Provider Identifier
1609206853
Registry record updated Feb 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
183833 Issued in TN
Practice address
1300 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2826
Phone
(800) 243-3839
NPI assigned
Nov 24, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 23, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X 18660 TN
Registered Nurse 163W00000X 183833 TN Primary

Addresses

Primary practice location

1300 Sawgrass Corporate Pkwy
Sunrise, FL 33323-2826

Mailing address

1341 Riverbrook Dr
Hermitage, TN 37076-3570
Phone (615) 342-4660

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
183833TNMDRegistered Nurse
18660TNMDNeonatal Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1385251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645574400000",
    "number": "1609206853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1341 RIVERBROOK DR",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370763570",
            "telephone_number": "615-342-4660",
            "fax_number": "615-342-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 SAWGRASS CORPORATE PKWY",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232826",
            "telephone_number": "800-243-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KERI",
        "middle_name": "NICOLE",
        "name_prefix": "Miss",
        "credential": "R.N., N.N.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-24",
        "last_updated": "2022-02-23",
        "certification_date": "2022-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "TN",
            "license": "18660",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "183833",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunrise, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.