Individual provider Active NPI

Anne M Jordan, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Memphis, TN
National Provider Identifier
1881764801
Registry record updated Jan 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
17218 Issued in TN
Practice address
5959 Park Ave
Memphis, TN 38119-5200
Phone
(901) 765-2131
Fax
(901) 765-2064
NPI assigned
Nov 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 17218 TN Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X E1849 AR

Addresses

Primary practice location

5959 Park Ave
Memphis, TN 38119-5200

Mailing address

PO Box 1483
Indianapolis, IN 46206-1483
Phone (877) 262-6446

Other identifiers 2

IdentifierTypeStateIssuer
113599001MedicaidAR
1525187MedicaidTN

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041012001082 TN Practitioner - Pathology 1557321809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Tennessee, HSC, College of Medicine, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Pathology Group PCGroup PAC ID 8022916006, 6 clinicians

Practice addresses (Care Compare)

5959 Park Ave
Memphis, TN 38119-5200
Phone (801) 765-2731

Hospital & facility affiliations

  • St Francis Hospital Hospital, Memphis, TN, CCN 440183
  • Saint Francis Bartlett Medical Center Hospital, Bartlett, TN, CCN 440228

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E1849ARMDAnatomic Pathology & Clinical Pathology Physician
17218TNMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Group PC Current Accepting new patients

Locations

6029 Walnut Grove Rd
Ste 300
Memphis, TN 38120

Organizations & group practices 3

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 2

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": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485820800000",
    "number": "1881764801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1483",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462061483",
            "telephone_number": "877-262-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 PARK AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195200",
            "telephone_number": "901-765-2131",
            "fax_number": "901-765-2064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ANNE",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-08",
        "last_updated": "2017-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TN",
            "license": "17218",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "AR",
            "license": "E1849",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "113599001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1525187",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.