Jordan Cecil Childers, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

05453 Issued in KY

Practice address

81 Ball Park Rd
Harlan, KY 40831-1701

Phone

(606) 573-8100

NPI assigned

Jun 1, 2020

Last updated

Apr 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Internal Medicine

Education

University of Pikeville, Kentucky College of Osteopathic Med, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Concord Medical Group of Kentucky PLLCGroup PAC ID 9133483894, 78 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Highlands Arh Regional Medical Center Hospital, Prestonsburg, KY, CCN 180005
• AdventHealthManchester Hospital, Manchester, KY, CCN 180043

Merit-based Incentive Payment System (MIPS)

Final score

96.15 of 100Reported as group

Quality

82.35

Improvement activities

40

Cost

83.51

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• Concord Medical Group of Kentucky PLLC

  • Emergency Medicine Physician
  • Hardinsburg, KY
  • NPI 1346746385
  Medicare reassignment Care Compare group NPD
• Floyd Emergency Group, LLC

  • Emergency Medicine Physician
  • Prestonsburg, KY
  • NPI 1760834345
  Medicare reassignment NPD
• Green Valley Emergency Physicians, LLC

  • Emergency Medicine Physician
  • Paducah, KY
  • NPI 1720755739
  Medicare reassignment NPD
• Williamson Emergency Physicians LLC

  • Emergency Medicine Physician
  • South Williamson, KY
  • NPI 1740492644
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arh Tug Valley Health Services, Inc.

  dba Highlands ARH Regional Medical Center

  • General Acute Care Hospital
  • Prestonsburg, KY
  • NPI 1043878325
  Care Compare affiliation
• Arh Tug Valley Health Services, Inc.

  dba ARH Medical and Surgical Associates - Highlands

  • Multi-Specialty Clinic/Center
  • Prestonsburg, KY
  • NPI 1700445319

  Hospital

  Care Compare affiliation
• Memorial Hospital, Inc.

  dba Adventhealth Manchester

  • Rural Acute Care Hospital
  • Manchester, KY
  • NPI 1811922347
  Care Compare affiliation

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1699399121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 572",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "413110572",
            "telephone_number": "606-548-2610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 BALL PARK RD",
            "city": "HARLAN",
            "state": "KY",
            "postal_code": "408311701",
            "telephone_number": "606-573-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDERS",
        "first_name": "JORDAN",
        "middle_name": "CECIL",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-01",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "05453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jameel Butt, MD
• Ashley Leann Caldwell, LPCC
• Carl E. Smith, M.D., F.a.a.P., PLLC
• Carole Kiphart Bays PSC
• Gregory Lynn Carpenter, M.D.
• Larry Wayne Childers
• Tammy Chorak, PMH-NP
• Clover Fork Outpatient Medical Project Inc
• Kayla Alissa Collett, PTA
• Rebecca Lynn Collett, RN, BSN

• Internal Medicine Physician in Harlan, KY
• Providers in Harlan, KY by specialty
• Internal Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.