Paul Alan Jordan

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

Practice address

533 Pelham Rd
533 Pelham Road
Philadelphia, PA 19119-4002

Phone

(215) 713-4347

NPI assigned

Jan 29, 2010

Last updated

Jan 29, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Paul Alan Jordan Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1264723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264723200000",
    "number": "1700117835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "533 PELHAM RD",
            "address_2": "533 PELHAM ROAD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191194002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "533 PELHAM RD",
            "address_2": "533 PELHAM ROAD",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191194002",
            "telephone_number": "215-713-4347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "PAUL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-29",
        "last_updated": "2010-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "JORDAN",
            "middle_name": "ALAN",
            "prefix": "MISS",
            "credential": "M.ED",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jeremy Robert Jordan, CRNP
• Joshua Jordan, DPT
• Kathleen Mary Jordan
• Kelton Jordan, D.C.
• Lazora Jordan
• Saundra Jordan, PHARMD
• Susan Margaret Jordan, RN
• Desiree Ann Jorden-Johnson, LCSW
• Kimberly Ann Jordon, RNFA
• Chiason Leigh Jorento, BSN, MSN

• Exclusive Provider Organization in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Exclusive Provider Organization in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2010; 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.