Jordan Agnew, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

61716 Issued in CA

Practice address

1627 E Anaheim St
Long Beach, CA 90813-3809

Phone

(562) 218-8181

NPI assigned

May 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: jordan.agnew.1@14654.direct.athenahealth.com

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.

• Janice L. Hull, M.D., Inc.

  • Obstetrics & Gynecology Physician
  • Inglewood, CA
  • NPI 1013156520
  NPD
• James L. Hull, M.D., Inc

  • Obstetrics & Gynecology Physician
  • Inglewood, CA
  • NPI 1962723965
  NPD (past)

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

{
    "created_epoch": "1590278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1609499763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 PETALUMA AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153529",
            "telephone_number": "562-209-0012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 E ANAHEIM ST",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908133809",
            "telephone_number": "562-218-8181"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8475 S Van Ness Ave Ste 101",
            "address_purpose": "LOCATION",
            "city": "Inglewood",
            "state": "CA",
            "postal_code": "903051566",
            "country_code": "US",
            "telephone_number": "323-778-7990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "AGNEW",
        "first_name": "JORDAN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-24",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "61716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reshma Gulati Aggarwal, M.D.
• Latifa Aghattass
• Agile Team Homecare Services LLC
• Agmmm Pharmacy Inc
• Jennifer Elizabeth Agnew, PHARM. D
• Mannat Agnish, MD, MPH
• Shelley Eileen Agrusa, RN
• Christopher Kanayo Agu, N/A
• Petra Agu
• Daisy Aguayo Araiza

• Physician Assistant in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; 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.