Active NPI
Michelle Ruthann Jordan, PT
- Physical Therapist
- Kingsport, TN
National Provider Identifier
1922128081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6155
- Practice address
- 2971 Fort Henry Dr
Kingsport, TN 37664-4005 - Phone
- (423) 230-8450
- NPI assigned
- Mar 30, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6155 | TN | Primary |
Addresses
Primary practice location
2971 Fort Henry Dr
Kingsport, TN 37664-4005
Mailing address
110 Robindale CT
Kingsport, TN 37663
Phone (423) 726-2083
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6155 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922128081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 ROBINDALE CT",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "37663",
"telephone_number": "423-726-2083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2971 FORT HENRY DR",
"city": "KINGSPORT",
"state": "TN",
"postal_code": "376644005",
"telephone_number": "423-230-8450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "MICHELLE",
"middle_name": "RUTHANN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "6155",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kingsport, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.