Charlotte Elizabeth Jordan

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP61151908 Issued in WA

Practice address

4686 Pointes Dr Ste 219
Mukilteo, WA 98275-6038

Phone

(425) 405-8089

Fax

(425) 426-2277

NPI assigned

May 10, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

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.

• Village Family Health PS

  • Primary Care Nurse Practitioner
  • Bellingham, WA
  • NPI 1871625970

  Family

  NPD (past)

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

{
    "created_epoch": "1620604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1730763400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4764 S GOLF COURSE DR",
            "city": "BLAINE",
            "state": "WA",
            "postal_code": "982306816",
            "telephone_number": "360-441-3892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4686 POINTES DR STE 219",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982756038",
            "telephone_number": "425-405-8089",
            "fax_number": "425-426-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CHARLOTTE",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-10",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61151908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Jones
• Bernard Scott Jones, D.C.
• Griffith Jones, DMSC, PA-C
• Michael Anthony Jones Jr.
• Alexandra Jordan, PT, DPT
• Emily Joselyn
• Danielle Marie Joyce
• Tshiteya Kabuika
• John Kae, PHARMD
• Paul S Kahlon, D.M.D.

• Family Nurse Practitioner in Mukilteo, WA
• Providers in Mukilteo, WA by specialty
• Family Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.