Individual provider Active NPI

Cynthia Jordan, PA-C

  • Medical Physician Assistant
  • Dayton, OH
National Provider Identifier
1720528714
Registry record updated Feb 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
50.005021RX Issued in OH
Practice address
1989 Miamisburg Centerville Rd Ste 201
Dayton, OH 45459-3858
Phone
(937) 401-7575
Fax
(937) 522-8350
NPI assigned
Feb 24, 2017
Last updated
Feb 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005021RX OH
Medical Physician Assistant 363AM0700X 50.005021RX OH Primary

Addresses

Primary practice location

1989 Miamisburg Centerville Rd Ste 201
Dayton, OH 45459-3858

Mailing address

1989 Miamisburg Centerville Rd Ste 201
Dayton, OH 45459-3858
Phone (937) 401-7575

Other identifiers 1

IdentifierTypeStateIssuer
0212452MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170330001318 OH Practitioner - Physician Assistant 5496030652 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

1989 Miamisburg Centerville Rd
Suite 201
Centerville, OH 45459-3858
Phone (937) 401-7575

4403 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 433-5309

4441 Far Hills Ave
Kettering, OH 45429-2405
Phone (937) 298-7751

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005021RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Specialists Inc Physician Assistant CurrentSince Mar 20, 2017 Accepting new patients
Alliance Physicians Inc CurrentSince Nov 1, 2017 Accepting new patients
Premier Health Specialists Inc CurrentSince Mar 20, 2017 Accepting new patients
Alliance Physicians, Inc. CurrentSince Nov 1, 2017 Accepting new patients

Locations

122 Wyoming St
Dayton, OH 45409
Phone (937) 438-8640

1989 Miamisburg Centerville Rd
Ste 201
Dayton, OH 45459
Phone (937) 401-7575

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

4000 Miamisburg Centerville Rd
Ste 410
Miamisburg, OH 45342
Phone (937) 384-4511

450 N Hyatt St
Ste 304
Tipp City, OH 45371
Phone (937) 832-4773

4353 E State Route 73
Ste 150
Waynesville, OH 45068
Phone (513) 855-4336

1625 S Alex Rd
West Carrollton, OH 45449
Phone (937) 865-0534

Interoperability endpoints

  • Direct secure messaging: cjordan598492@direct.ketteringhealth.org

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.

Hospital & facility affiliations 2

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": "1487894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1720528714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1989 MIAMISBURG CENTERVILLE RD STE 201",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593858",
            "telephone_number": "937-401-7575",
            "fax_number": "937-522-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1989 MIAMISBURG CENTERVILLE RD STE 201",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454593858",
            "telephone_number": "937-401-7575",
            "fax_number": "937-522-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CYNTHIA",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-24",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005021RX",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50.005021RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0212452",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dayton, OH

Sources for this page

Verify at the official NPI Registry.