NPIMap

Individual provider Active NPI

Caitlin Altman Jordan, PA-C

  • Medical Physician Assistant
  • Lake City, SC
National Provider Identifier
1831745710
Registry record updated Jan 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
3226 Issued in SC
Practice address
276 N Ron McNair Blvd
Lake City, SC 29560-2462
Phone
(843) 792-1414
NPI assigned
Aug 15, 2019
Last updated
Jan 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 3226 SC Primary

Addresses

Primary practice location

276 N Ron McNair Blvd
Lake City, SC 29560-2462

Mailing address

PO Box 23467
New York, NY 10087-3221
Phone (843) 792-6200

Other practice location 1

360 N Irby St
Florence, SC 29501-2808
Phone (843) 667-9414

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210331001253 SC Practitioner - Physician Assistant 5799192159 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

148 Sauls St
Lake City, SC 29560-2677
Phone (843) 374-3621

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3226SCMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Hopehealth, Inc. CurrentSince Feb 1, 2021 Accepting new patients
Hopehealth Inc CurrentSince Feb 1, 2021 Accepting new patients
Medical University Hospital Authority CurrentSince Nov 21, 2022 Accepting new patients
Medical University Hospital Authority CurrentSince Nov 21, 2022 Accepting new patients
Medical University Hospital Authority Past Accepting new patients
Medical University Hospital Authority Past Accepting new patients
Hopehealth, Inc. Past Accepting new patients

Locations

360 N Irby St
Florence, SC 29501
Phone (843) 656-0353

600 E Palmetto St
Florence, SC 29506
Phone (843) 656-0390

276 N Ron McNair Blvd
Lake City, SC 29560
Phone (843) 394-1051

511 S Main St
Mullins, SC 29574
Phone (843) 464-8244

Interoperability endpoints

  • Direct secure messaging: cjordan411315@direct.musc.edu

Organizations & group practices 8

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 8

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674172800000",
    "number": "1831745710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23467",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873221",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "276 N RON MCNAIR BLVD",
            "city": "LAKE CITY",
            "state": "SC",
            "postal_code": "295602462",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "360 N Irby St",
            "address_purpose": "LOCATION",
            "city": "Florence",
            "state": "SC",
            "postal_code": "295012808",
            "country_code": "US",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "CAITLIN",
        "middle_name": "ALTMAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2023-01-20",
        "certification_date": "2023-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "SC",
            "license": "3226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "276 N Ron McNair Blvd",
            "city": "Lake City",
            "state": "SC",
            "country_code": "US",
            "postal_code": "295602462",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake City, SC

Sources for this page

Verify at the official NPI Registry.