Individual provider Active NPI

Jordan Palmer, HOLISTIC HEALTH

  • Health Educator
  • Lexington, KY
National Provider Identifier
1871313890
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
Practice address
4384 Clearwater Way Ste 190
Lexington, KY 40515-6493
Phone
(859) 403-3385
NPI assigned
Oct 14, 2024
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 7

Specialty (taxonomy)CodeLicenseStatePrimary
Acupuncturist 171100000X NU
Naturopath 175F00000X NU
Homeopath 175L00000X NU
Obesity Medicine (Psychiatry & Neurology) Physician 2084B0002X 124197182 KY
Behavior Analyst 103K00000X NU
Health Educator 174H00000X NU Primary
Health & Wellness Coach 171400000X NU

Addresses

Primary practice location

4384 Clearwater Way Ste 190
Lexington, KY 40515-6493

Mailing address

4384 Clearwater Way Ste 190
Lexington, KY 40515-6493
Phone (859) 403-3385

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
124197182KYMDObesity Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rewind Medical, LLC Health & Wellness Coach CurrentSince Oct 20, 2024 Accepting new patients

Locations

4384 Clearwater Way
Ste 190
Lexington, KY 40515
Phone (859) 403-3385

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, 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": "1728864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1871313890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4384 CLEARWATER WAY STE 190",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156493",
            "telephone_number": "859-403-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4384 CLEARWATER WAY STE 190",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156493",
            "telephone_number": "859-403-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "JORDAN",
        "name_prefix": "Prof.",
        "credential": "HOLISTIC HEALTH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-14",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175F00000X",
            "taxonomy_group": "",
            "desc": "Naturopath",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "175L00000X",
            "taxonomy_group": "",
            "desc": "Homeopath",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084B0002X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Obesity Medicine",
            "state": "KY",
            "license": "124197182",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; 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.