Individual provider Active NPI

Anita Jordan

  • Counselor
  • Brandon, FL
National Provider Identifier
1790021145
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Practice address
135 N Moon Ave
Brandon, FL 33510-4419
Phone
(813) 689-8828
NPI assigned
Dec 12, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X Primary

Addresses

Primary practice location

135 N Moon Ave
Brandon, FL 33510-4419

Mailing address

135 N Moon Ave
Brandon, FL 33510-4419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210601000163 FL Practitioner - Clinical Social Worker 5092114785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grow Healthcare Group PAGroup PAC ID 3476961368, 1,045 clinicians

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807
Phone (786) 244-7711

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Anita Inner Healing and Counseling Current Accepting new patients
Grow Healthcare Group PA CurrentSince May 28, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

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": "1355270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1790021145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 N MOON AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N MOON AVE",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335104419",
            "telephone_number": "813-689-8828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ANITA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

Verify at the official NPI Registry.