Individual provider Active NPI

Randy A Jordan, MD

  • Interventional Cardiology Physician
  • Little Rock, AR
National Provider Identifier
1780695312
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
C-5657 Issued in AR
Practice address
10100 Kanis Rd
Little Rock, AR 72205-6202
Phone
(501) 255-6000
Fax
(501) 255-6400
NPI assigned
Aug 10, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X C-5657 AR
Interventional Cardiology Physician 207RI0011X C-5657 AR Primary

Addresses

Primary practice location

10100 Kanis Rd
Little Rock, AR 72205-6202

Mailing address

10100 Kanis Rd
Little Rock, AR 72205-6202
Phone (501) 255-6000

Other identifiers 2

IdentifierTypeStateIssuer
110321001MedicaidAR
89-T033OtherARMALP INS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20040225000437 AR Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Other (Physician) 3779479910 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Heart Clinic Arkansas Cardiovascular Disease Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
St. Vincent Infirmary Medical Center Current Accepting new patients
Baptist Health Cardiovascular Disease CurrentSince Feb 1, 1994 Accepting new patients
St Vincent Infirmary Medical Center CurrentSince May 1, 1999 Accepting new patients
St Vincent Infirmary Medical Center CurrentSince May 1, 1999 Accepting new patients
Baptist Health CurrentSince Feb 1, 1994 Accepting new patients
Baptist Health Past Accepting new patients
Hill Medical Services, PLLC PastSince Jan 31, 2012 Accepting new patients

Locations

1 Saint Vincent Cir
Little Rock, AR 72205
Phone (479) 878-2250

10100 Kanis Rd
Little Rock, AR 72205
Phone (501) 255-6000

2 Saint Vincent Cir
Little Rock, AR 72205
Phone (501) 552-2680

9601 Baptist Health Dr
Little Rock, AR 72205
Phone (501) 202-3995

9601 Interstate 630
Little Rock, AR 72205
Phone (501) 202-2300

1708 N Buerkle St
Stuttgart, AR 72160
Phone (870) 659-8050

Organizations & group practices 9

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1780695312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10100 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056202",
            "telephone_number": "501-255-6000",
            "fax_number": "501-255-6400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10100 KANIS RD",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722056202",
            "telephone_number": "501-255-6000",
            "fax_number": "501-255-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "RANDY",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AR",
            "license": "C-5657",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AR",
            "license": "C-5657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110321001",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MALP INS",
            "identifier": "89-T033",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little Rock, AR

Sources for this page

Verify at the official NPI Registry.