Active NPI
Kelli Lynn Jordan, PHARMD
- Pharmacist
- Covington, LA
National Provider Identifier
1831344761
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 19056
- Practice address
- 70431 Highway 21
Winn Dixie
Covington, LA 70433-8103 - Phone
- (985) 898-1195
- Fax
- (985) 871-8151
- NPI assigned
- Nov 19, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 15905 | AL | |
| Pharmacist | 183500000X | 19056 | LA | Primary |
Addresses
Primary practice location
70431 Highway 21
Winn Dixie
Covington, LA 70433-8103
Mailing address
70431 Highway 21
Winn Dixie
Covington, LA 70433-8103
Phone (985) 898-1195
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19056 | LA | MD | Pharmacist |
| 15905 | AL | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1227052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275609600000",
"number": "1831344761",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70431 HIGHWAY 21",
"address_2": "WINN DIXIE",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704338103",
"telephone_number": "985-898-1195",
"fax_number": "985-871-8151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70431 HIGHWAY 21",
"address_2": "WINN DIXIE",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704338103",
"telephone_number": "985-898-1195",
"fax_number": "985-871-8151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "KELLI",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-11-19",
"last_updated": "2010-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AL",
"license": "15905",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "LA",
"license": "19056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Covington, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.