Active NPI
Timothy W Jordan, MD
- Pediatrics Physician
- Spokane, WA
National Provider Identifier
1669442612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD00046301
- Practice address
- 101 W 8TH Ave
Suite 4200
Spokane, WA 99204-2307 - Phone
- (509) 474-2730
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 26988 | AZ | |
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | MD00046301 | WA | |
| Pediatrics Physician | 208000000X | MD00046301 | WA | Primary |
Addresses
Primary practice location
101 W 8TH Ave
Suite 4200
Spokane, WA 99204-2307
Mailing address
PO Box 31001-4114
Pasadena, CA 91110-0001
Phone (509) 474-2730
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 508658 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26988 | AZ | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755734400000",
"number": "1669442612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 31001-4114",
"city": "PASADENA",
"state": "CA",
"postal_code": "911100001",
"telephone_number": "509-474-2730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 W 8TH AVE",
"address_2": "SUITE 4200",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992042307",
"telephone_number": "509-474-2730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "TIMOTHY",
"middle_name": "W",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2025-08-21",
"certification_date": "2025-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AZ",
"license": "26988",
"primary": false
},
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "WA",
"license": "MD00046301",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00046301",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "508658",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.