Jordyn Nicole Dorman

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

209024585 Issued in IL

Practice address

3333 N Seminary St
Galesburg, IL 61401-1251

Phone

(309) 344-6161

NPI assigned

Dec 16, 2021

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

Medicare fee-for-service enrollment

Enrolled in IL

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

State licenses

Practice roles

Locations

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.

• Graham Hospital Association

  • Critical Access Hospital
  • Canton, IL
  • NPI 1780692087
  Medicare reassignment NPD
• Central Prairie Physicians PLLC

  • Emergency Medicine Physician
  • Lubbock, TX
  • NPI 1821884750

  IL

  Medicare reassignment NPD
• Graham Hospital Association

  • Rural Health Clinic/Center
  • Galesburg, IL
  • NPI 1194462101
  NPD
• Graham Hospital Association

  • Internal Medicine Physician
  • Galesburg, IL
  • NPI 1710845854
  NPD

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

{
    "created_epoch": "1639612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1730848862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 W OLD VINE ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "61520",
            "telephone_number": "309-259-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 N SEMINARY ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614011251",
            "telephone_number": "309-344-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORMAN",
        "first_name": "JORDYN",
        "middle_name": "NICOLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-16",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "IL",
            "license": "209024585",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "IL",
            "license": "041503368",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nathan Curtis Dieckow, O.D.
• Karley Divan, MA, LPC
• Andre DO, PHARMD
• Jessica Donaldson
• Emily Kelly Dooley, MD
• Dr Thomas M Kovacik
• William J Duensing, DO
• Tabitha Durdle, MHP
• Katarina Dutra, MHP
• Deborah Jon Dyer, HID

• Acute Care Nurse Practitioner in Galesburg, IL
• Providers in Galesburg, IL by specialty
• Acute Care Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.