Individual provider Active NPI

Ronald H Jordan, MD

  • Anesthesiology Physician
  • Mobile, AL
National Provider Identifier
1780654905
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
11978 Issued in AL
Practice address
5 Mobile Infirmary Cir
Mobile, AL 36607-3513
Phone
(251) 432-4497
Fax
(251) 432-0577
NPI assigned
Jan 23, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 11978 AL Primary

Addresses

Primary practice location

5 Mobile Infirmary Cir
Mobile, AL 36607-3513

Mailing address

PO Box 934369
Atlanta, GA 31193-0001
Phone (800) 897-6169

Other identifiers 1

IdentifierTypeStateIssuer
000057281MedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100803000397 AL Practitioner - AnesthesiologyPractitioner - Pain Management 6709877913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
11978ALMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists Associated PC CurrentSince May 1, 2018 Accepting new patients
Anesthesiologists Associated PC Anesthesiology CurrentSince May 1, 2018 Accepting new patients
Imc- Mobile OB/GYN Ctr PC Past Accepting new patients

Locations

701 Princeton Ave SW
Birmingham, AL 35211
Phone (205) 279-2860

3701 Dauphin St
Mobile, AL 36608
Phone (251) 341-3368

5 Mobile Infirmary Cir
Mobile, AL 36607
Phone (251) 432-4415

Networks

  • bcbs alabama network 01H0
  • bcbs alabama network 01E0
  • bcbs alabama network 01A0
  • bcbs alabama network 01B0
  • bcbs alabama network 01G0

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1780654905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 934369",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311930001",
            "telephone_number": "800-897-6169",
            "fax_number": "800-897-6170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 MOBILE INFIRMARY CIR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366073513",
            "telephone_number": "251-432-4497",
            "fax_number": "251-432-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "RONALD",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "AL",
            "license": "11978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000057281",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.