Individual provider Active NPI

Albert Kevin Jordan, PSY.D.

  • Clinical Psychologist
  • Scottsdale, AZ
National Provider Identifier
1831440791
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
3426 Issued in AZ
Practice address
10005 E Osborn Rd
Scottsdale, AZ 85256-4019
Phone
(480) 362-5495
Fax
(480) 362-5692
NPI assigned
Oct 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 3426 AZ Primary

Addresses

Primary practice location

10005 E Osborn Rd
Scottsdale, AZ 85256-4019

Mailing address

10005 E Osborn Rd
Scottsdale, AZ 85256-4019
Phone (480) 362-5495

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

LicenseStateTypeSpecialty
3426AZMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349049600000",
    "number": "1831440791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10005 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852564019",
            "telephone_number": "480-362-5495",
            "fax_number": "480-362-5692"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10005 E OSBORN RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852564019",
            "telephone_number": "480-362-5495",
            "fax_number": "480-362-5692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ALBERT",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-01",
        "last_updated": "2012-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AZ",
            "license": "3426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.