Individual provider Active NPI

Jordan McIntosh Sibol, PA-C

  • Physician Assistant
  • Timonium, MD
National Provider Identifier
1902329576
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
C0006624 Issued in MD
Practice address
2219 York Rd Ste 102
Timonium, MD 21093-3140
Phone
(410) 453-0002
Fax
(410) 453-0380
NPI assigned
Jul 25, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X C0006624 MD Primary

Addresses

Primary practice location

2219 York Rd Ste 102
Timonium, MD 21093-3140

Mailing address

5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700

Other practice location 1

8000 Loch Raven Blvd
Towson, MD 21286-8337
Phone (410) 616-9027

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20171220001763 DC Practitioner - Physician Assistant 6204194269 Reassigns benefits to 3 organizations
I20171221002058 MD Practitioner - Physician Assistant 6204194269 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medstar Urgent Care LLCGroup PAC ID 9335303155, 300 clinicians

Practice addresses (Care Compare)

12 Medstar Blvd
Bel Air, MD 21015-1798
Phone (410) 877-8087

6317 York Rd
Baltimore, MD 21212-2310
Phone (443) 777-6890

6500 Baltimore National Pike
Catonsville, MD 21228-4200
Phone (410) 807-8067

8605 Ridgelys Choice Dr
Nottingham, MD 21236-2953
Phone (410) 248-2310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Medstar Urgent Care LLC CurrentSince Apr 11, 2021 Accepting new patients
Medstar Urgent Care, LLC CurrentSince Apr 11, 2021 Accepting new patients
MNR Industries, LLC CurrentSince Oct 18, 2017 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Oct 18, 2017 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Feb 15, 2018 Accepting new patients
Medstar Urgent Care LLC CurrentSince Apr 11, 2021 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Feb 15, 2018 Accepting new patients
Patient First Maryland Medical Group, PLLC Current Accepting new patients
MNR Industries LLC CurrentSince Oct 18, 2017 Accepting new patients
Patient First Maryland Medical Group PLLC CurrentSince Feb 15, 2018 Accepting new patients
Ez Primed LLC PastSince Jun 4, 2023 Accepting new patients

Locations

6317 York Rd
Baltimore, MD 21212
Phone (443) 777-6890

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

6000 Laurel Bowie Rd
Bowie, MD 20715
Phone (301) 383-0330

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

10210 Reisterstown Rd
Owings Mills, MD 21117
Phone (410) 902-6776

10210 Reisterstown Rd
#12302
Owings Mills, MD 21117
Phone (410) 902-6776

8105 Ritchie Hwy
Pasadena, MD 21122
Phone (443) 573-0564

726 Rockville Pike
Rockville, MD 20852
Phone (240) 238-0411

8000 Loch Raven Blvd
Towson, MD 21286
Phone (410) 616-9027

2855 Crain Hwy
Waldorf, MD 20601
Phone (240) 427-1926

3064 Waldorf Market Pl
Waldorf, MD 20603
Phone (301) 932-5960

11915 Georgia Ave
Wheaton, MD 20902
Phone (301) 942-4505

5000 Cox Rd
Glen Allen, VA 23060
Phone (804) 822-4355

Interoperability endpoints

  • Direct secure messaging: jordan.lawson.1@22522.direct.athenahealth.com

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1902329576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 YORK RD STE 102",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210933140",
            "telephone_number": "410-453-0002",
            "fax_number": "410-453-0380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8000 Loch Raven Blvd",
            "address_purpose": "LOCATION",
            "city": "Towson",
            "state": "MD",
            "postal_code": "212868337",
            "country_code": "US",
            "telephone_number": "410-616-9027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIBOL",
        "first_name": "JORDAN",
        "middle_name": "MCINTOSH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0006624",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Timonium, MD

Sources for this page

Verify at the official NPI Registry.