Individual provider Active NPI

Jordan Lee Nordquist, MD

  • Child & Adolescent Psychiatry Physician
  • Johnstown, CO
National Provider Identifier
1679835615
Registry record updated Jun 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
DR.0064502 Issued in CO
Practice address
4901 Thompson Pkwy
Johnstown, CO 80534-6426
Phone
(303) 338-4545
NPI assigned
Jun 14, 2012
Last updated
Jun 17, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 565422 TX
Child & Adolescent Psychiatry Physician 2084P0804X 10033 SD
Child & Adolescent Psychiatry Physician 2084P0804X DR.0064502 CO Primary

Addresses

Primary practice location

4901 Thompson Pkwy
Johnstown, CO 80534-6426

Mailing address

10350 E Dakota Ave
Denver, CO 80247-1314

Other identifiers 1

IdentifierTypeStateIssuer
029064OtherCOKAISER COMMERCIAL NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways Health Information Exchange (HIE)

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
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
565422TXMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Healthcare CurrentSince Sep 10, 2023 Accepting new patients
Rosebud Indian Health Service CurrentSince Mar 3, 2018 Accepting new patients
Eagle Butte Indian Health Service Hospital CurrentSince Jun 2, 2018 Accepting new patients
Comprehensive Healthcare CurrentSince Sep 10, 2023 Accepting new patients
Rosebud Indian Health Service CurrentSince Mar 3, 2018 Accepting new patients
Quentin N Burdick Comprehensive Health Care Facility CurrentSince Jan 20, 2018 Accepting new patients
Haaku Health Past Accepting new patients

Locations

1300 Hospital Loop
Belcourt, ND 58316

4100 W 150th St
#3
Cleveland, OH 44135

402 S 4th Ave
Yakima, WA 98902
Phone (509) 575-3874

Interoperability endpoints

  • Direct secure messaging: jordan.nordquist@avera.sdhealthlink.net

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1339632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623888000000",
    "number": "1679835615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10350 E DAKOTA AVE",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802471314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4901 THOMPSON PKWY",
            "city": "JOHNSTOWN",
            "state": "CO",
            "postal_code": "805346426",
            "telephone_number": "303-338-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORDQUIST",
        "first_name": "JORDAN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-14",
        "last_updated": "2021-06-17",
        "certification_date": "2021-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "565422",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "SD",
            "license": "10033",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CO",
            "license": "DR.0064502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "029064",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4901 Thompson Pkwy",
            "city": "Johnstown",
            "state": "CO",
            "country_code": "US",
            "postal_code": "805346426",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Johnstown, CO

Sources for this page

Verify at the official NPI Registry.