Jennifer M Jordan, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

71001204A Issued in IN

Practice address

14540 Prairie Lakes Blvd N Ste 200
Noblesville, IN 46060-4370

Phone

(317) 578-4193

NPI assigned

Jan 3, 2006

Last updated

Oct 31, 2018By 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

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbh.jenniferjordan@140099.advancedmd-direct.com

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.

• Midwest Behavioral Health LLC

  dba dba LifeStance Health

  • Psychiatry Physician
  • Evansville, IN
  • NPI 1427362201
  Medicare reassignment NPD

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1639157480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 96TH ST # 520",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462601316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14540 PRAIRIE LAKES BLVD N STE 200",
            "city": "NOBLESVILLE",
            "state": "IN",
            "postal_code": "460604370",
            "telephone_number": "317-578-4193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JENNIFER",
        "middle_name": "M",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "IN",
            "license": "71001204A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Derrick A Johnston, DDS
• Esther Michele Jones, M.D.
• James P Jones, PHD, HSPP
• Jordan Fonseca LLC
• Grace Jordan
• Jennifer Elizabeth Joseph, MSW, LCSW
• Josephson-Wallack-Munshower Neurology PC (JWM Neurology PC)
• Joshua Terhune LLC
• Lauren Judge
• Dorothy Juergensen, NBHWC, LSW

• Pediatric Nurse Practitioner in Noblesville, IN
• Providers in Noblesville, IN by specialty
• Pediatric Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.