Jordan Rose Stevens, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

55160 Issued in ID

Practice address

110 Vista Dr
Pocatello, ID 83201-5824

Phone

(208) 234-2300

NPI assigned

Feb 2, 2017

Last updated

Aug 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ID

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

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Primary Care Specialists PAGroup PAC ID 4082699574, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lost Rivers Medical Center Hospital, Arco, ID, CCN 131324
• Portneuf Medical Center Hospital, Pocatello, ID, CCN 130028

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Primary Care Specialists, PA

  • Primary Care Clinic/Center
  • Pocatello, ID
  • NPI 1508875881
  Medicare reassignment Care Compare group
• Cardiovascular Specialists of America, LLC

  • Clinical Cardiac Electrophysiology Physician
  • Pocatello, ID
  • NPI 1871190215
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lost Rivers Medical Center

  • Critical Access Hospital
  • Arco, ID
  • NPI 1114925047
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Rehabilitation Center

  • Rehabilitation Hospital Unit
  • Pocatello, ID
  • NPI 1144262114
  Care Compare affiliation
• Pocatello Hospital LLC

  dba Portneuf Medical Center

  • General Acute Care Hospital
  • Pocatello, ID
  • NPI 1790751055
  Care Compare affiliation

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

{
    "created_epoch": "1485993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1851839542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 VISTA DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 VISTA DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832015824",
            "telephone_number": "208-234-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "JORDAN",
        "middle_name": "ROSE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-02",
        "last_updated": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "55160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George H Stephens, M.D.
• Scott Stephenson, D.M.D.
• Stepping Stones Counseling and Mediation LLC
• Stepping Stones Counseling and Mediation LLC
• Jessica Sterling, CADC
• Michael L Stevens, LCSW
• Azure Kate Stevenson
• Sharhonda Chantell Stevenson, MA, LPC, NCC ,MDFT
• Ryan Stewart, PT
• Still Waters, Incorporated

• Family Nurse Practitioner in Pocatello, ID
• Providers in Pocatello, ID by specialty
• Family Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.