Active NPI
Tacarra Simone Jordan
- Registered Nurse
- Northport, AL
National Provider Identifier
1801477914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 1-143328
- Practice address
- 2700 Hospital Dr
Northport, AL 35476-3360 - Phone
- (205) 333-4970
- NPI assigned
- Apr 20, 2021
- Last updated
- Apr 20, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 1-143328 | AL | Primary |
Addresses
Primary practice location
2700 Hospital Dr
Northport, AL 35476-3360
Mailing address
225 30TH Ave E
Tuscaloosa, AL 35404-2664
Phone (205) 523-2911
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1-143328 | AL | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1801477914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "225 30TH AVE E",
"city": "TUSCALOOSA",
"state": "AL",
"postal_code": "354042664",
"telephone_number": "205-523-2911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 HOSPITAL DR",
"city": "NORTHPORT",
"state": "AL",
"postal_code": "354763360",
"telephone_number": "205-333-4970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "TACARRA",
"middle_name": "SIMONE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "AL",
"license": "1-143328",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northport, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.