Randall G. Jordan, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

634 Issued in AL

Practice address

1841 Honeysuckle Rd
Dothan, AL 36305-4269

Phone

(334) 794-2113

Fax

(334) 702-1220

NPI assigned

Oct 31, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Clinical Psychologist

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Faith and Therapy, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Dothan, AL
  • NPI 1639800477
  NPD

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

{
    "created_epoch": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1801887799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1841 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054269",
            "telephone_number": "334-794-2113",
            "fax_number": "334-702-1220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1841 HONEYSUCKLE RD",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363054269",
            "telephone_number": "334-794-2113",
            "fax_number": "334-702-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "RANDALL",
        "middle_name": "G.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AL",
            "license": "634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104596",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Latosha Jones
• Lauren Baileah Jones, RBT
• Pamela Jones, CRNP
• Patrick William Jones, M.D.
• Stephen W Jones, MD
• Tami Savage Jordan, LPC
• Leah Dawn Josefosky, CRNP NNP-BC
• Clifford W Joyner, CRNA
• Joel Jules, DO, PHD
• Jeffery Charles Justice, M.S., LPC

• Clinical Psychologist in Dothan, AL
• Providers in Dothan, AL by specialty
• Clinical Psychologist in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.