NPIMap

Individual provider Active NPI

Terri Polito Jordan, ARNP, BC-GNP

  • Registered Nurse
  • Cocoa, FL
National Provider Identifier
1700070695
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
RN 1705612 Issued in FL
Practice address
846 N Cocoa Blvd
Suite a
Cocoa, FL 32922-7544
Phone
(321) 453-5535
NPI assigned
Sep 4, 2007
Last updated
Jun 2, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN 1705612 FL Primary

Addresses

Primary practice location

846 N Cocoa Blvd
Suite a
Cocoa, FL 32922-7544

Mailing address

846 N Cocoa Blvd
Ste a Tehc Health Care
Cocoa, FL 32922-7544
Phone (321) 453-5535

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
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN 1705612FLMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Services of Central Florida, PLC Past Accepting new patients
Metcare of Florida, Inc Past Accepting new patients
After-Hours Pediatric Family Care Center PLC Past Accepting new patients
Metcare of Florida, Inc Past Accepting new patients
Carelon Medical Partners of Kansas, PA Past Accepting new patients

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, 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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1700070695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "846 N COCOA BLVD",
            "address_2": "STE A TEHC HEALTH CARE",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227544",
            "telephone_number": "321-453-5535",
            "fax_number": "321-456-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "846 N COCOA BLVD",
            "address_2": "SUITE A",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227544",
            "telephone_number": "321-453-5535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TERRI",
        "middle_name": "POLITO",
        "name_prefix": "Mrs.",
        "credential": "ARNP, BC-GNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN 1705612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cocoa, FL

Sources for this page

Verify at the official NPI Registry.