Eleacia Lerayne Jordan

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

611 N 4TH St
Stilwell, OK 74960-2417

Phone

(918) 696-6212

NPI assigned

Apr 7, 2025

Last updated

Apr 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1902690977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N 4TH ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749602417",
            "telephone_number": "918-696-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N 4TH ST",
            "city": "STILWELL",
            "state": "OK",
            "postal_code": "749602417",
            "telephone_number": "918-696-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ELEACIA",
        "middle_name": "LERAYNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Denise James, CNP
• Jessica Ann Jarvis, PARAPROFESSIONAL
• Jeffery L. Jenkins, M.D.
• Janel Johnson, D.O.
• Jared Jones
• Angela S Kester
• Stephanie L Killough
• Lisa Nicole Kimble
• Brenda Kincaid
• Megan Nicole Kirk, M.S., CCC-SLP

• Peer Specialist in Stilwell, OK
• Providers in Stilwell, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; 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.