NPIMap

Individual provider Active NPI

Staci M Jordan, M.D.

  • Family Medicine Physician
  • Overland Park, KS
National Provider Identifier
1831185750
Registry record updated Apr 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
0429110 Issued in KS
Practice address
6740 W 121St St # 250
Overland Park, KS 66209-2002
Phone
(913) 261-9380
Fax
(913) 375-1229
NPI assigned
Sep 26, 2005
Last updated
Apr 17, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 0429110 KS Primary

Addresses

Primary practice location

6740 W 121St St # 250
Overland Park, KS 66209-2002

Mailing address

6740 W 121St St # 250
Overland Park, KS 66209-2002
Phone (913) 261-9380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Apr 8, 2026 through Apr 8, 2028

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Missouri, Kansas City, School of Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ability KCGroup PAC ID 0143116368, 166 clinicians

Practice addresses (Care Compare)

3011 Baltimore Ave
Kansas City, MO 64108-3403
Phone (816) 751-7832

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0429110KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Overland Park Surgical Specialties LLC Family Medicine CurrentSince Feb 5, 2019 Accepting new patients
College Park Family Care Center PA Family Medicine Past Accepting new patients
College Park Family Care Center, P.a. Past Accepting new patients
College Park Family Care Center, P.a. Past Accepting new patients

Locations

11725 W 112th St
Overland Park, KS 66210
Phone (913) 469-5452

11725 W 112th St
Ste 101
Overland Park, KS 66210

11755 W 112th St
Ste 101
Overland Park, KS 66210
Phone (913) 469-0503

10500 Quivira Rd
Shawnee Mission, KS 66215
Phone (913) 227-0565

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: staci.jordan@hca2.eclinicaldirectplus.com

Organizations & group practices 5

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776384000000",
    "number": "1831185750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6740 W 121ST ST # 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092002",
            "telephone_number": "913-261-9380",
            "fax_number": "913-375-1229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 W 121ST ST # 250",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662092002",
            "telephone_number": "913-261-9380",
            "fax_number": "913-375-1229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "STACI",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2026-04-17",
        "certification_date": "2026-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "0429110",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.