Individual provider Active NPI

Jaudonna P Jordan

  • Mental Health Counselor
  • Memphis, TN
National Provider Identifier
1902006034
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1087 Alice Ave
Memphis, TN 38106-6543
Phone
(901) 259-1920
Fax
(901) 259-1922
NPI assigned
Jul 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X TN Primary
Counselor 101Y00000X TN

Addresses

Primary practice location

1087 Alice Ave
Memphis, TN 38106-6543

Mailing address

1303 Glenn St
Memphis, TN 38106-4321
Phone (901) 259-1920

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

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184716800000",
    "number": "1902006034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1303 GLENN ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381064321",
            "telephone_number": "901-259-1920",
            "fax_number": "901-259-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 ALICE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381066543",
            "telephone_number": "901-259-1920",
            "fax_number": "901-259-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "JAUDONNA",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TN",
            "license": null,
            "primary": true
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TN",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.