Lenise Marlena Jordan, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN162420 Issued in GA

Practice address

6085 Old National Hwy Ste G
South Fulton, GA 30349-4333

Phone

(844) 644-4325

Fax

(855) 583-3678

NPI assigned

Mar 5, 2014

Last updated

May 3, 2024By 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 GA

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

Specialty

Nurse Practitioner

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Centerwell Senior Primary Care Ga PCGroup PAC ID 3274939061, 56 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lenise.jordan.1@29601.direct.athenahealth.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.

• Centerwell Senior Primary Care Ga PC

  dba CenterWell Senior Primary Care-Old National

  • Internal Medicine Physician
  • South Fulton, GA
  • NPI 1801463468
  Medicare reassignment Care Compare group NPD
• Centerwell Senior Primary Care Ga PC

  dba CenterWell Senior Primary Care-Woodstock

  • Internal Medicine Physician
  • Woodstock, GA
  • NPI 1689491680
  NPD

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

{
    "created_epoch": "1393977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714694400000",
    "number": "1639595309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6085 OLD NATIONAL HWY STE G",
            "city": "SOUTH FULTON",
            "state": "GA",
            "postal_code": "303494333",
            "telephone_number": "844-644-4325",
            "fax_number": "855-583-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6085 OLD NATIONAL HWY STE G",
            "city": "SOUTH FULTON",
            "state": "GA",
            "postal_code": "303494333",
            "telephone_number": "844-644-4325",
            "fax_number": "855-583-3678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "LENISE",
        "middle_name": "MARLENA",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-03-05",
        "last_updated": "2024-05-03",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN162420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in South Fulton, GA
• Providers in South Fulton, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2024; 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.
• 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.