Individual provider Active NPI

Denis Jordan, CPA

  • Prosthetist
  • Pasadena, CA
National Provider Identifier
1720628142
Registry record updated Jan 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
CPA00219
Practice address
909 S Fair Oaks Ave
Pasadena, CA 91105-2625
Phone
(213) 368-3374
Fax
(213) 639-3454
NPI assigned
Jan 14, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetist 224P00000X CPA00219 Primary

Addresses

Primary practice location

909 S Fair Oaks Ave
Pasadena, CA 91105-2625

Mailing address

2900 N Rocky Point Dr
Tampa, FL 33607-1435
Phone (813) 518-7832

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL email

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1578960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578960000000",
    "number": "1720628142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N ROCKY POINT DR",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336071435",
            "telephone_number": "813-518-7832",
            "fax_number": "813-518-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 S FAIR OAKS AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911052625",
            "telephone_number": "213-368-3374",
            "fax_number": "213-639-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "DENIS",
        "credential": "CPA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-01-14",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": "CPA00219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "email",
            "affiliation": "N",
            "address_1": "909 S Fair Oaks Ave",
            "city": "Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "911052625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.