Individual provider Active NPI

Jennifer Luvenia Jordan

  • Driver
  • Glenn Heights, TX
National Provider Identifier
1689169815
Registry record updated Jun 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
Practice address
701 Shady Meadow LN
Glenn Heights, TX 75154-7923
Phone
(972) 697-9713
NPI assigned
Jun 29, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 29, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X Primary

Addresses

Primary practice location

701 Shady Meadow LN
Glenn Heights, TX 75154-7923

Mailing address

701 Shady Meadow LN
Glenn Heights, TX 75154-7923
Phone (972) 697-9713

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530230400000",
    "number": "1689169815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SHADY MEADOW LN",
            "city": "GLENN HEIGHTS",
            "state": "TX",
            "postal_code": "751547923",
            "telephone_number": "972-697-9713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SHADY MEADOW LN",
            "city": "GLENN HEIGHTS",
            "state": "TX",
            "postal_code": "751547923",
            "telephone_number": "972-697-9713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JENNIFER",
        "middle_name": "LUVENIA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2018-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Heights, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.