Deannah Marie Jordan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101278658 Issued in VA

Practice address

1529 International Blvd Ste 103
Norfolk, VA 23513-4802

Phone

(757) 855-6800

NPI assigned

Apr 9, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Deannah Marie Dick Former name

Medicare fee-for-service enrollment

Enrolled in VA

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

Pediatric Medicine

Education

Drexel University College of Medicine, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Childrens Medical Group Inc

  dba Norfolk Pediatrics

  • Pediatrics Physician
  • Norfolk, VA
  • NPI 1629546106
  Medicare reassignment
• Childrens Medical Group Inc

  dba General Booth Pediatrics

  • Pediatrics Physician
  • Virginia Beach, VA
  • NPI 1366597114
  NPD (past)

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

{
    "created_epoch": "1586390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686528000000",
    "number": "1700405859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8468 JANE WAY",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235034008",
            "telephone_number": "814-270-3065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1529 INTERNATIONAL BLVD STE 103",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235134802",
            "telephone_number": "757-855-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DEANNAH",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-09",
        "last_updated": "2023-06-12",
        "certification_date": "2023-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101278658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DEANNAH",
            "last_name": "DICK",
            "middle_name": "MARIE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Makeyah Jones
• Mesha Lawan Jones, MSN,RN
• Michael Brandon Jones, PA-C
• Monique Ashanti Jones
• Tiffany A Jones, RDH
• Glenda Jordan
• Grace Anne Jordan, PA
• Laura Kozoyed Jordan, RPH
• Malcolm Augustin Jordan
• Phillip Jordan

• Pediatrics Physician in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.