Individual provider Active NPI

Ella Perry Jordan, MS CCC-SLP

  • Speech-Language Pathologist
  • Apex, NC
National Provider Identifier
1760125462
Registry record updated Apr 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
15306 Issued in NC
Practice address
800 W Williams St Ste 231N
Apex, NC 27502-5204
Phone
(919) 610-9298
NPI assigned
Apr 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 15306 NC Primary

Addresses

Primary practice location

800 W Williams St Ste 231N
Apex, NC 27502-5204

Mailing address

1700 Parkview Dr
Elizabeth City, NC 27909-6648
Phone (252) 531-4141

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230717002290 NC Practitioner - Qualified Speech Language Pathologist 7618337080 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
15306NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
North Carolina Eye Ear Nose & Throat PA PastSince Jun 16, 2006 Accepting new patients

Locations

1010 Tryon Village Dr
#701
Cary, NC 27518

1838 Martin Luther King Jr Blvd
Chapel Hill, NC 27514
Phone (919) 442-2506

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

4102 N Roxboro St
Durham, NC 27704
Phone (919) 595-2000

5726 Fayetteville Rd
Ste 102
Durham, NC 27713
Phone (919) 682-9341

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650931200000",
    "number": "1760125462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 PARKVIEW DR",
            "city": "ELIZABETH CITY",
            "state": "NC",
            "postal_code": "279096648",
            "telephone_number": "252-531-4141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W WILLIAMS ST STE 231N",
            "city": "APEX",
            "state": "NC",
            "postal_code": "275025204",
            "telephone_number": "919-610-9298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ELLA",
        "middle_name": "PERRY",
        "credential": "MS CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2022-04-26",
        "certification_date": "2022-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "15306",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apex, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.