Individual provider Active NPI

Jordan Nicole Langhan

  • Family Nurse Practitioner
  • Fayetteville, GA
National Provider Identifier
1831780584
Registry record updated Dec 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F10220708 Issued in GA
Practice address
1267 Highway 54 W Ste 4200
Fayetteville, GA 30214-2112
Phone
(678) 829-1060
Fax
(678) 829-1099
NPI assigned
Jan 26, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN261552 GA
Family Nurse Practitioner 363LF0000X F10220708 GA Primary

Addresses

Primary practice location

1267 Highway 54 W Ste 4200
Fayetteville, GA 30214-2112

Mailing address

1267 Highway 54 W Ste 4200
Fayetteville, GA 30214-2112
Phone (678) 829-1060

Other names 1

  • Jordan Nicole Vincent Former name

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: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN261552GAMDRegistered Nurse
F10220708GAMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670976000000",
    "number": "1831780584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 4200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142112",
            "telephone_number": "678-829-1060",
            "fax_number": "678-829-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1267 HIGHWAY 54 W STE 4200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142112",
            "telephone_number": "678-829-1060",
            "fax_number": "678-829-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGHAN",
        "first_name": "JORDAN",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2022-12-14",
        "certification_date": "2022-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN261552",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "F10220708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "VINCENT",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

Verify at the official NPI Registry.