Jordan Alyse Healy McDaniel

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

T-5468 Issued in MS

Practice address

2500 N State St
Jackson, MS 39216-4500

Phone

(601) 984-1000

NPI assigned

Mar 27, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

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

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: jordan.mcdaniel.1@20428.direct.athenahealth.com

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

{
    "created_epoch": "1711497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1649021981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 THORNGATE DR",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390422334",
            "telephone_number": "228-547-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 N STATE ST",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164500",
            "telephone_number": "601-984-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "JORDAN",
        "middle_name": "ALYSE HEALY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-27",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MS",
            "license": "T-5468",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leisa Annette McCullough, CCC-SLP
• Evan Pike McCutchen
• Brandon Thomas McDaniel, MD
• Elijah McDaniel
• Jennifer Eden McDaniel, CPNP-AC
• Kassia Ellen McDaniel, ACNP-BC
• Kori McDaniel, D.O.
• Patrick McDaniel, MD
• James Patrick McDavid, CFNP
• Reagan Paige McDevitt

• Internal Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Internal Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.