Active NPI
Benjamin Edward Jordan, M.D.
- Diagnostic Radiology Physician
- Nashville, TN
National Provider Identifier
1669606992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 51300
- Practice address
- 210 25TH Ave N
Suite 602
Nashville, TN 37203 - Phone
- (615) 312-0600
- Fax
- (615) 320-3259
- NPI assigned
- May 15, 2009
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 34238 | AL | |
| Diagnostic Radiology Physician | 2085R0202X | 51300 | TN | Primary |
Addresses
Primary practice location
210 25TH Ave N
Suite 602
Nashville, TN 37203
Mailing address
601 Dodds Ave
Chattanooga, TN 37404-3911
Phone (866) 730-5619
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04357014 | Medicaid | MS | |
| 511-61752 | Other | AL | BLUE CROSS BLUE SHIELD |
| Q006343 | Medicaid | TN | |
| 172629 | Medicaid | AL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, KY, OH
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Radiology
- Education
- University of Tennessee, HSC, College of Medicine, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
100 Aqua Way
Apt 101
Newport, KY 41071-2197
Phone (615) 917-6090
3000 Hospital Dr
Batavia, OH 45103-1921
Phone (513) 732-8200
Hospital & facility affiliations
- Mercy Health - West Hospital
- Mercy Health - Fairfield Hospital
- Mercy Health - Clermont Hospital
- Adena Regional Medical Center
- HMHP St Elizabeth Boardman Health Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34238 | AL | MD | Diagnostic Radiology Physician |
| 51300 | TN | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clarksville Imaging Center LLC | Diagnostic Radiology | Current | Accepting new patients |
| Middle Tennessee Imaging LLC | Diagnostic Radiology | Current | Accepting new patients |
| Columbus Radiology Corp | Diagnostic Radiology | Current | Accepting new patients |
| Adi Radiology PC | Diagnostic Radiology | Current | Accepting new patients |
Locations
2330 Utah Ave
#200
El Segundo, CA 90245
Phone (281) 766-9059
3000 Hospital Dr
Batavia, OH 45103
Phone (513) 557-3209
111 S Grant Ave
Columbus, OH 43215
Phone (614) 461-3232
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
Hospital & facility affiliations 6
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Chillicothe, OH
- NPI 1902839673
-
- General Acute Care Hospital
- Batavia, OH
- NPI 1568562551
-
- General Acute Care Hospital
- Fairfield, OH
- NPI 1467552471
-
- General Acute Care Hospital
- Cincinnati, OH
- NPI 1912007931
-
- General Acute Care Hospital
- Youngstown, OH
- NPI 1790868982
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242345600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1669606992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 DODDS AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374043911",
"telephone_number": "866-730-5619",
"fax_number": "423-698-3622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 25TH AVE N",
"address_2": "SUITE 602",
"city": "NASHVILLE",
"state": "TN",
"postal_code": "37203",
"telephone_number": "615-312-0600",
"fax_number": "615-320-3259"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "BENJAMIN",
"middle_name": "EDWARD",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-15",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "AL",
"license": "34238",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "TN",
"license": "51300",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04357014",
"state": "MS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "511-61752",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q006343",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "172629",
"state": "AL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 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.
- 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.