Individual provider Active NPI

Takenya Lacole Jordan

  • Prosthetics Case Management
  • Albany, GA
National Provider Identifier
1851908016
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
Practice address
2231 Dawson Rd Ste Ij
Albany, GA 31707-3227
Phone
(229) 938-2083
Fax
(888) 780-7250
NPI assigned
Sep 30, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X Primary

Addresses

Primary practice location

2231 Dawson Rd Ste Ij
Albany, GA 31707-3227

Mailing address

2231 Dawson Rd Ste Ij
Albany, GA 31707-3227
Phone (229) 938-2083

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

Practice roles

OrganizationSpecialtyStatusNew patients
Albany Beauty Academy LLC Prosthetics Case Management CurrentSince Oct 1, 2024 Accepting new patients

Locations

2231 Dawson Rd
Ste Ij
Albany, GA 31707
Phone (229) 938-2083

2231 Dawson Rd
Ste I
Albany, GA 31707

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1601424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1851908016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2231 DAWSON RD STE IJ",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073227",
            "telephone_number": "229-938-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2231 DAWSON RD STE IJ",
            "city": "ALBANY",
            "state": "GA",
            "postal_code": "317073227",
            "telephone_number": "229-938-2083",
            "fax_number": "888-780-7250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "TAKENYA",
        "middle_name": "LACOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-30",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albany, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.