Individual provider Active NPI

Cynthia Belinda Jordan, REGISTERED NURSE

  • Registered Nurse
  • Lake Elsinore, CA
National Provider Identifier
1619337250
Registry record updated Feb 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
624255 Issued in CA
Practice address
29344 Gateway Dr
Lake Elsinore, CA 92530-7255
Phone
(951) 579-1099
Fax
(951) 579-1099
NPI assigned
Feb 24, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 624255 CA Primary

Addresses

Primary practice location

29344 Gateway Dr
Lake Elsinore, CA 92530-7255

Mailing address

29344 Gateway Dr
Lake Elsinore, CA 92530-7255
Phone (951) 579-1099

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

State licenses

LicenseStateTypeSpecialty
624255CAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1456272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1619337250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29344 GATEWAY DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307255",
            "telephone_number": "951-579-1099",
            "fax_number": "951-579-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29344 GATEWAY DR",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925307255",
            "telephone_number": "951-579-1099",
            "fax_number": "951-579-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CYNTHIA",
        "middle_name": "BELINDA",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-24",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "624255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Elsinore, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.