Individual provider Active NPI

Jordan Wentworth, APRN, CPNP-PC

  • Pediatric Nurse Practitioner
  • Mt Pleasant, MI
National Provider Identifier
1861268237
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
4704432415 Issued in MI
Practice address
1970 Ashland Dr
Mount Pleasant, MI 48858-1203
Phone
(989) 772-1500
NPI assigned
Nov 28, 2023
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 4704432415 MI Primary
Registered Nurse 163W00000X 4704432415 MI
Registered Nurse 163W00000X 1-186169 AL

Addresses

Primary practice location

1970 Ashland Dr
Mount Pleasant, MI 48858-1203

Mailing address

1970 Ashland Dr
Mount Pleasant, MI 48858-1203
Phone (989) 772-1500

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

State licenses

LicenseStateTypeSpecialty
1-186169ALMDRegistered Nurse
4704432415MIMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Children's Hospital of Alabama CurrentSince Jul 29, 2024 Accepting new patients
The Children's Hospital of Alabama PastSince Dec 3, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1701129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1861268237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1970 ASHLAND DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488581203",
            "telephone_number": "989-772-1500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 ASHLAND DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488581203",
            "telephone_number": "989-772-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENTWORTH",
        "first_name": "JORDAN",
        "credential": "APRN, CPNP-PC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-28",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MI",
            "license": "4704432415",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704432415",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-186169",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2026; 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.