Jordan Edward Nutt, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN172181 Issued in GA

Practice address

510 Ruby Forest Pkwy
Suwanee, GA 30024-3930

Phone

(770) 654-2171

NPI assigned

Sep 9, 2015

Sex

Male

Sole proprietor

Yes

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 GA

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

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 and National Provider Directory roles.

• Emerginet Henry, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1811946627
  Medicare reassignment NPD
• Emerginet, LLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Atlanta, GA
  • NPI 1164480869
  Medicare reassignment NPD
• Northside Emergency Associates, LLC

  • Emergency Medicine Physician
  • Sandy Springs, GA
  • NPI 1285686303
  Medicare reassignment NPD
• Walker Lake Emergency Group, PC

  • Emergency Medicine Physician
  • Conyers, GA
  • NPI 1437629342
  Medicare reassignment NPD
• Parkway Anesthesia Consultants, PC

  • Certified Registered Nurse Anesthetist
  • Villa Rica, GA
  • NPI 1194887455
  NPD (past)

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

{
    "created_epoch": "1441756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441756800000",
    "number": "1871961847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 RUBY FOREST PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300243930",
            "telephone_number": "770-654-2171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 RUBY FOREST PKWY",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300243930",
            "telephone_number": "770-654-2171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTT",
        "first_name": "JORDAN",
        "middle_name": "EDWARD",
        "credential": "NP-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-09",
        "last_updated": "2015-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN172181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Danielle Nugent, PA-S
• Nuhaven of Hope Inc
• Yasmin Nuru, NP
• Tonya Nussbaum, AUD
• Courtney Nutt
• Nneka J Nwaobi, RPH
• Shawn Thomas O'Connor, ATC
• Oculofacial Plastic Surgeons of Georgia, LLC
• Sandra Oh, DMD
• Amauwia Okivie, NP

• Family Nurse Practitioner in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.