Chantal Elise Jordan

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

39942 Issued in TN

Practice address

804 Keylon St
Manchester, TN 37355-2414

Phone

(931) 455-2674

Fax

(931) 455-8983

NPI assigned

Jun 16, 2025

Last updated

Jun 15, 2026By the provider in NPPES

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)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Tullahoma Pediatrics PLLC

  • Pediatrics Physician
  • Tullahoma, TN
  • NPI 1770562142
  NPD (past)

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781481600000",
    "number": "1629964846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 KEYLON ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552414",
            "telephone_number": "931-455-2674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 KEYLON ST",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373552414",
            "telephone_number": "931-455-2674",
            "fax_number": "931-455-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CHANTAL",
        "middle_name": "ELISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-16",
        "last_updated": "2026-06-15",
        "certification_date": "2026-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TN",
            "license": "39942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy Jenkins, DPT
• Jeremy and Summer Anderson
• Hamidreza Cody Jobehdari, PHARM. D
• Teagan Perry Jones, PA-C
• Vickie Jones, CFNP
• Patricia W Jordan, APN
• Jamie Keele, OD
• Katherine Elizabeth Keen Saunders, D.D.S.
• Linda Elaine Kennedy, RN
• Laura N Kimball, NP

• Pediatric Nurse Practitioner in Manchester, TN
• Providers in Manchester, TN by specialty
• Pediatric Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2026; 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.