Individual provider Active NPI

Danny Jordan, MPT

  • Physical Therapist
  • Palm Desert, CA
National Provider Identifier
1609957463
Registry record updated Sep 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT27640 Issued in CA
Practice address
42080 State Street
Palm Desert, CA 92211-5173
Phone
(760) 568-2894
Fax
(760) 346-4179
NPI assigned
Oct 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT27640 CA Primary

Addresses

Primary practice location

42080 State Street
Palm Desert, CA 92211-5173

Mailing address

42080 State Street
Palm Desert, CA 92211-5173
Phone (760) 568-2894

Other identifiers 3

IdentifierTypeStateIssuer
2233960OtherFIRST HEALTH
5673015OtherFIRST HEALTH
P00328755OtherPALMETTO GBA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041115000357 CA Practitioner - Physical Therapist in Private Practice 0547224180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Physical Therapy Center IncGroup PAC ID 8325093693, 7 clinicians

Practice addresses (Care Compare)

42080 State St
Suite a
Palm Desert, CA 92211-5173
Phone (760) 568-2894

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27640CAMDDental Hygienist
PT27640CAMDPhysical Therapist

Organizations & group practices 1

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": "1161129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1609957463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42080 STATE STREET",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922115173",
            "telephone_number": "760-568-2894",
            "fax_number": "760-346-4179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42080 STATE STREET",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922115173",
            "telephone_number": "760-568-2894",
            "fax_number": "760-346-4179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DANNY",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT27640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2233960",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5673015",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "P00328755",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.