NPIMap

Individual provider Active NPI

Seth Jordan, APRN

  • Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1669139036
Registry record updated Feb 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
25222 Issued in SC
Practice address
111 Doctor Cir
Columbia, SC 29203-6502
Phone
(800) 491-0909
Fax
(844) 828-7365
NPI assigned
Nov 20, 2021
Last updated
Feb 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X GAA-NP000484 GA
Nurse Practitioner 363L00000X 25222 SC Primary

Addresses

Primary practice location

111 Doctor Cir
Columbia, SC 29203-6502

Mailing address

111 Doctor Cir
Columbia, SC 29203-6502
Phone (800) 491-0909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220209002255 GA Practitioner - Nurse Practitioner 2466845771 Reassigns benefits to 2 organizations
I20221012000097 SC Practitioner - Nurse Practitioner 2466845771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
SC House Calls IncGroup PAC ID 6800994807, 445 clinicians

Practice addresses (Care Compare)

1053 Ctr St
West Columbia, SC 29169-6749
Phone (800) 491-0909

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
92.67
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
GAA-NP000484GAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Hospice, Inc Current Accepting new patients
SC House Calls Inc CurrentSince Sep 26, 2022 Accepting new patients
SC House Calls Inc CurrentSince Sep 26, 2022 Accepting new patients
Pruitthealth Hospice, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Pruitthealth Hospice, Inc. CurrentSince Nov 1, 2021 Accepting new patients
Physicians at Home PC PastSince Nov 1, 2021 Accepting new patients

Locations

1109 Medical Center Dr
Ste 2A
Augusta, GA 30909
Phone (706) 901-4242

2565 Thompson Bridge Rd
Ste 114
Gainesville, GA 30501

6060 Lakeside Commons Dr
Macon, GA 31210
Phone (478) 745-9204

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

9100 White Bluff Rd
Ste 303
Savannah, GA 31406
Phone (470) 610-6430

9100 White Bluff Rd
Ste 305
Savannah, GA 31406
Phone (912) 925-9183

111 Doctor Cir
Columbia, SC 29203
Phone (803) 730-8910

1624 Main St
Columbia, SC 29201
Phone (803) 454-0365

1053 Center St
West Columbia, SC 29169
Phone (803) 454-0365

Interoperability endpoints

  • Direct secure messaging: seth.jordan.1@7602.direct.athenahealth.com

Organizations & group practices 6

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.

Hospital & facility affiliations 10

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": "1637366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676592000000",
    "number": "1669139036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DOCTOR CIR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036502",
            "telephone_number": "800-491-0909",
            "fax_number": "844-828-7365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SETH",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-20",
        "last_updated": "2023-02-17",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "GAA-NP000484",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "25222",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.