Individual provider Active NPI

Jordan James Stiverson, MD

  • Urology Physician
  • Wichita, KS
National Provider Identifier
1891321378
Registry record updated Nov 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
04-51415 Issued in KS
Practice address
2626 N Webb Rd
Wichita, KS 67226-8110
Phone
(316) 636-6100
Fax
(316) 636-5813
NPI assigned
Mar 17, 2020
Last updated
Nov 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 04-51415 KS Primary

Addresses

Primary practice location

2626 N Webb Rd
Wichita, KS 67226-8110

Mailing address

2626 N Webb Rd
Wichita, KS 67226-8110
Phone (316) 636-6100

Other practice location 1

2077 N Webb Rd
Wichita, KS 67206-3411
Phone (316) 636-6100

Other practice location 2

7570 W 21st St N Ste 1014A
Wichita, KS 67205-1764
Phone (316) 636-6100

Other practice location 3

1600 E 1st St
Pratt, KS 67124-2070
Phone (316) 636-6100

Other practice location 4

1515 N Clifton Ave
Ste 250
Wichita, KS 67218
Phone (316) 636-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20250617001515 KS Practitioner - Urology 2466876503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wichita Urology Group PAGroup PAC ID 7214904499, 29 clinicians

Practice addresses (Care Compare)

2626 N Webb Rd
Wichita, KS 67226-8110
Phone (316) 636-6100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
04-51415KSMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wichita Urology Group P.a. Urology CurrentSince Aug 4, 2025 Accepting new patients
Kansas Spine Anesthesia Corporation PA PastSince Aug 4, 2025 Accepting new patients

Locations

1600 E 1st St
Pratt, KS 67124
Phone (620) 770-4117

2077 N Webb Rd
Wichita, KS 67206
Phone (316) 636-6100

2626 N Webb Rd
Wichita, KS 67226
Phone (316) 636-6100

7570 W 21st St N
Ste 1014A
Wichita, KS 67205
Phone (316) 636-6100

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.

Hospital & facility affiliations 7

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": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763942400000",
    "number": "1891321378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N WEBB RD",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672268110",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2077 N Webb Rd",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672063411",
            "country_code": "US",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7570 W 21st St N Ste 1014A",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "672051764",
            "country_code": "US",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 E 1st St",
            "address_purpose": "LOCATION",
            "city": "Pratt",
            "state": "KS",
            "postal_code": "671242070",
            "country_code": "US",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1515 N Clifton Ave",
            "address_2": "Ste 250",
            "address_purpose": "LOCATION",
            "city": "Wichita",
            "state": "KS",
            "postal_code": "67218",
            "country_code": "US",
            "telephone_number": "316-636-6100",
            "fax_number": "316-636-5813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STIVERSON",
        "first_name": "JORDAN",
        "middle_name": "JAMES",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-17",
        "last_updated": "2025-11-24",
        "certification_date": "2025-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "KS",
            "license": "04-51415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.