Individual provider Active NPI

Jordan Lang, APRN

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1881322394
Registry record updated Oct 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32242 Issued in TN
Practice address
9330 Park West Blvd Ste 302
Knoxville, TN 37923-4311
Phone
(865) 373-7975
Fax
(865) 374-2145
NPI assigned
Aug 11, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 32242 TN Primary

Addresses

Primary practice location

9330 Park West Blvd Ste 302
Knoxville, TN 37923-4311

Mailing address

2213 Griffitts Mill Cir
Maryville, TN 37803-2568

Other identifiers 1

IdentifierTypeStateIssuer
Q077723MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lang.jordan@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20221025002601 TN Practitioner - Nurse Practitioner 9830565324 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Lincoln Memorial University Medical Department, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians

Practice addresses (Care Compare)

9330 Park W Blvd
Suite 302
Knoxville, TN 37923-4311
Phone (865) 373-7975

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
32242TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group, Inc. CurrentSince Sep 19, 2022 Accepting new patients
Covenant Medical Group, Inc CurrentSince Sep 19, 2022 Accepting new patients

Locations

Dept 888179
Knoxville, TN 37995

9330 Park West Blvd
Ste 302
Knoxville, TN 37923
Phone (865) 373-7975

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

Interoperability endpoints

  • Direct secure messaging: lang.jordan@covenanthealth.cernerdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1660176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1881322394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2213 GRIFFITTS MILL CIR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378032568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 PARK WEST BLVD STE 302",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234311",
            "telephone_number": "865-373-7975",
            "fax_number": "865-374-2145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "JORDAN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-11",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q077723",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lang.jordan@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9330 Park West Blvd Ste 302",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.