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Individual provider Active NPI

Jordan Daniel Walters, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Tallahassee, FL
National Provider Identifier
1720406945
Registry record updated Nov 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME143624 Issued in FL
Practice address
3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308-4470
Phone
(850) 877-8174
Fax
(844) 261-6839
NPI assigned
Apr 4, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME143624 FL Primary
Orthopaedic Surgery Physician 207X00000X ME143624 FL

Addresses

Primary practice location

3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308-4470

Mailing address

3334 Capital Medical Blvd Ste 400
Tallahassee, FL 32308-4470
Phone (850) 877-8174

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200730001233 FL Practitioner - Sports MedicinePractitioner - Orthopedic Surgery 5890026702 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Orthopedic Surgery
Education
Wake Forest University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2605 Welaunee Blvd
Tallahassee, FL 32308-4697
Phone (850) 877-8174

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
76.5 of 100Reported as group
Quality
47.27
Promoting interoperability
99
Improvement activities
40
Cost
75.24

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement1-10
Knee replacement27
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Tallahassee Orthopedic Clinic III PL Orthopaedic Surgery CurrentSince Aug 1, 2020 Accepting new patients
Tallahassee Orthopedic Clinic III, P.L. CurrentSince Aug 1, 2020 Accepting new patients
Hospital Authority of the City of Bainbridge and Decatur County Past Accepting new patients

Locations

224 NW Crane Ave
Madison, FL 32340
Phone (850) 253-1923

803 W Main St
Perry, FL 32347
Phone (850) 584-7078

3334 Capital Medical Blvd
Ste 400
Tallahassee, FL 32308

3334 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 210-1808

2605 Welaunee Blvd
Tallahassee, FL 32308
Phone (850) 219-1932

Interoperability endpoints

  • Direct secure messaging: jordan.walters.1@18802.direct.athenahealth.com

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637625600000",
    "number": "1720406945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "844-261-6839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3334 CAPITAL MEDICAL BLVD STE 400",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084470",
            "telephone_number": "850-877-8174",
            "fax_number": "844-261-6839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTERS",
        "first_name": "JORDAN",
        "middle_name": "DANIEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-04-04",
        "last_updated": "2021-11-23",
        "certification_date": "2021-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME143624",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME143624",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.