Individual provider Active NPI

Taylor R Jordan, M.D.

  • Diagnostic Radiology Physician
  • Eden Prairie, MN
National Provider Identifier
1629391305
Registry record updated Jul 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A97803 Issued in CA
Practice address
11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone
(952) 595-1301
Fax
(612) 294-4903
NPI assigned
Mar 9, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X A97803 CA
Diagnostic Radiology Physician 2085R0202X A97803 CA Primary

Addresses

Primary practice location

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349

Mailing address

11995 Singletree LN Ste 500
Eden Prairie, MN 55344-5349
Phone (952) 595-1301

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100507000711 CA Practitioner - Diagnostic Radiology 9133257306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
George Washington University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kern Radiology Medical Group IncGroup PAC ID 7214826460, 94 clinicians

Practice addresses (Care Compare)

2301 Bahamas Dr
Bakersfield, CA 93309-0663
Phone (661) 326-9600

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.38 of 100Reported as group
Quality
75
Promoting interoperability
100
Improvement activities
40
Cost
77.19

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A97803CAMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kern Radiology Medical Group, Inc Diagnostic Radiology CurrentSince Apr 26, 2022 Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology Current Accepting new patients

Locations

2301 Bahamas Dr
Bakersfield, CA 93309

9330 Stockdale Hwy
Ste 100
Bakersfield, CA 93311
Phone (661) 325-6800

1817 Truxtun Ave
Bakersfield, CA 93301
Phone (661) 325-6800

1818 16th St
Bakersfield, CA 93301
Phone (661) 616-1458

3838 San Dimas St
Ste A120
Bakersfield, CA 93301
Phone (661) 328-9600

4500 Morning Dr
Ste 202
Bakersfield, CA 93306
Phone (661) 326-6900

9920 Brimhall Rd
Bakersfield, CA 93312

9900 Stockdale Hwy
Ste 100
Bakersfield, CA 93311
Phone (661) 616-6306

432 S Mill St
Tehachapi, CA 93561
Phone (661) 822-8223

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625184000000",
    "number": "1629391305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11995 SINGLETREE LN STE 500",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553445349",
            "telephone_number": "952-595-1301",
            "fax_number": "612-294-4903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TAYLOR",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-09",
        "last_updated": "2021-07-02",
        "certification_date": "2021-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "A97803",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A97803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eden Prairie, MN

Sources for this page

Verify at the official NPI Registry.