Individual provider Active NPI

Jordan Ashford

  • Physician Assistant
  • Dacula, GA
National Provider Identifier
1831642875
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
008022 Issued in GA
Practice address
2089 Teron Trce Ste 200
Dacula, GA 30019-1609
Phone
(770) 962-5040
Fax
(470) 238-3078
NPI assigned
Jul 26, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 008022 GA Primary

Addresses

Primary practice location

2089 Teron Trce Ste 200
Dacula, GA 30019-1609

Mailing address

151 Southhall LN
Ste 300
Maitland, FL 32751-7172
Phone (407) 875-2080

Other names 1

  • Jordan K Daniell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170428001593 GA Practitioner - Physician Assistant 5597042580 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Skin Cancer and Aestheitic Dermatology, LLCGroup PAC ID 0244328649, 25 clinicians

Practice addresses (Care Compare)

1046 Salem Walk Dr
Greensboro, GA 30642-3811
Phone (706) 543-5858

1180 Resurgence Dr
Suite 100
Watkinsville, GA 30677-7210

1180 Resurgence Dr
Suite 100
Watkinsville, GA 30677-7211
Phone 70654358583207

Hospital & facility affiliations

  • Piedmont Athens Regional Medical Center Hospital, Athens, GA, CCN 110074
  • St Marys Good Samaritan Hospital Hospital, Greensboro, GA, CCN 111329

Merit-based Incentive Payment System (MIPS)

Final score
85.62 of 100Reported as group
Quality
78.23
Promoting interoperability
100
Improvement activities
40
Cost
73.84

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
008022GAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: jashford@georgiaderm.emadirect.md
  • Direct secure messaging: jordan.ashford@qdp.emadirect.md

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1831642875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 SOUTHHALL LN",
            "address_2": "STE 300",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327517172",
            "telephone_number": "407-875-2080",
            "fax_number": "407-650-3455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2089 TERON TRCE STE 200",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300191609",
            "telephone_number": "770-962-5040",
            "fax_number": "470-238-3078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHFORD",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-26",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "008022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "DANIELL",
            "middle_name": "K",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Dacula, GA

Sources for this page

Verify at the official NPI Registry.