Jordan Roberson, PMHNP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

APRN9410928 Issued in FL

Practice address

1737 N Clyde Morris Blvd Ste 300
Daytona Beach, FL 32117-5533

Phone

(386) 262-1627

NPI assigned

Jun 11, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jordan Rogers Former name

Medicare fee-for-service enrollment

Enrolled in FL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kopa LLCGroup PAC ID 5193774461, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HEBJCD

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.

• Kopa LLC

  • Multi-Specialty Clinic/Center
  • Orlando, FL
  • NPI 1417021114
  Medicare reassignment Care Compare group NPD
• Balanced Wellbeing LLC

  • Psychiatry Physician
  • Ocala, FL
  • NPI 1336513639
  Medicare reassignment NPD
• Ormond Family Medical Center PLLC

  • Family Medicine Physician
  • Ormond Beach, FL
  • NPI 1265192926

  Nurse Practitioner

  Medicare reassignment NPD
• NP by the Sea LLC

  • Clinic/Center
  • Ormond Beach, FL
  • NPI 1245983360
  NPD Authorized official

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781654400000",
    "number": "1669965000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1737 N CLYDE MORRIS BLVD STE 300",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175533",
            "telephone_number": "386-262-1627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1737 N CLYDE MORRIS BLVD STE 300",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321175533",
            "telephone_number": "386-262-1627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERSON",
        "first_name": "JORDAN",
        "credential": "PMHNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "APRN9410928",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100175900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "ROGERS",
            "credential": "ARNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Riley Rivers, STUDENT
• Reshina Renee Rix, RN
• Fadi Rizk, DO
• Erika Roach
• Lisa Robb, LCSW
• Robert B Hammond, DDS, PA
• Robert R. Young, M.D. P.a.
• Craig A. Roberto, M.D.
• James E Roberts, MD
• Rebecca Roberts, RBT

• Psychiatric/Mental Health Nurse Practitioner in Daytona Beach, FL
• Providers in Daytona Beach, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2026; 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.