Heather Nicole Jordan, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0007601 Issued in CO

Practice address

3532 Monroe St # 6322
Riverside, CA 92504-6322

Phone

(951) 552-8504

NPI assigned

Nov 8, 2022

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

Other names 1

• Heather Nicole Wood Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1861100950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 CATAMARAN LN",
            "city": "MONUMENT",
            "state": "CO",
            "postal_code": "801329012",
            "telephone_number": "970-620-7057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3532 MONROE ST # 6322",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925046322",
            "telephone_number": "951-552-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "HEATHER",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007601",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HEATHER",
            "last_name": "WOOD",
            "middle_name": "NICOLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandra Jordan
• Andre Jordan
• Denetrice Carol Jordan
• Desiree Jordan
• Devoneia Jordan
• Jeremy W Jordan, PA
• Landria Alysia Jordan
• Marisa Jordan
• Selina L Jordan, LMFT
• Jacqueline Jordon

• Physician Assistant in Riverside, CA
• Providers in Riverside, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.