Active NPI
Robert Lance Jordan
- Contractor
- Jacksonville, FL
National Provider Identifier
1912461393
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- Practice address
- 8485 Mizner Cir E
Jacksonville, FL 32217-4326 - Phone
- (518) 369-3328
- NPI assigned
- Jan 30, 2019
- Last updated
- Jan 30, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | Primary |
Addresses
Primary practice location
8485 Mizner Cir E
Jacksonville, FL 32217-4326
Mailing address
8485 Mizner Cir E
Jacksonville, FL 32217-4326
Phone (518) 369-3328
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": "1548806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548806400000",
"number": "1912461393",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8485 MIZNER CIR E",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322174326",
"telephone_number": "518-369-3328"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8485 MIZNER CIR E",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322174326",
"telephone_number": "518-369-3328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "ROBERT",
"middle_name": "LANCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-01-30",
"last_updated": "2019-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Jacksonville, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.