Individual provider Active NPI

Emily Michelle Jordan, ARNP

  • Nurse Practitioner
  • Pinehurst, NC
National Provider Identifier
1922317619
Registry record updated Apr 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5014262 Issued in NC
Practice address
15 Regional Dr
Pinehurst, NC 28374-8850
Phone
(910) 295-5511
NPI assigned
Sep 29, 2010
Last updated
Apr 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6622P KY
Nurse Practitioner 363L00000X 5014262 NC Primary
Primary Care Nurse Practitioner 363LP2300X 3006622 KY

Addresses

Primary practice location

15 Regional Dr
Pinehurst, NC 28374-8850

Mailing address

15 Regional Dr
Pinehurst, NC 28374-8850
Phone (910) 295-5511

Other practice location 1

1701 Ashley Cir Ste 200
Bowling Green, KY 42104-5816
Phone (270) 846-4800

Other practice location 2

615 7th Ave
Bowling Green, KY 42101-6921
Phone (270) 846-4800

Other identifiers 1

IdentifierTypeStateIssuer
7100140270MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210420000481 NC Practitioner - Nurse Practitioner 6002003712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Pinehurst Medical Clinic IncGroup PAC ID 5991617169, 162 clinicians

Practice addresses (Care Compare)

205 Page Rd
Pinehurst, NC 28374-8749
Phone (910) 295-5511

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6622PKYMDNurse Practitioner
5014262NCMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pinehurst Medical Clinic, Inc. CurrentSince Apr 12, 2021 Accepting new patients
Pinehurst Medical Clinic, Inc. CurrentSince Apr 12, 2021 Accepting new patients
Allergy Care Bowling Green Inc Past Accepting new patients
Pinehurst Medical Clinic Inc Past Accepting new patients
Pinehurst Medical Clinic, Inc. Past Accepting new patients

Locations

15 Regional Dr
Pinehurst, NC 28374
Phone (910) 255-4400

205 Page Rd
Pinehurst, NC 28374
Phone (910) 295-9211

200 Pavilion Way
Southern Pines, NC 28387
Phone (910) 235-3330

4208 Murdocksville Rd
West End, NC 27376
Phone (910) 235-5900

Interoperability endpoints

  • Direct secure messaging: ejordan954176@direct.unc.nchie.net
  • Direct secure messaging: emilyjordan@phmc.allscriptsdirect.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617321600000",
    "number": "1922317619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-295-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REGIONAL DR",
            "city": "PINEHURST",
            "state": "NC",
            "postal_code": "283748850",
            "telephone_number": "910-295-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1701 Ashley Cir Ste 200",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421045816",
            "country_code": "US",
            "telephone_number": "270-846-4800",
            "fax_number": "270-842-7177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "615 7th Ave",
            "address_purpose": "LOCATION",
            "city": "Bowling Green",
            "state": "KY",
            "postal_code": "421016921",
            "country_code": "US",
            "telephone_number": "270-846-4800",
            "fax_number": "270-846-4828",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "EMILY",
        "middle_name": "MICHELLE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2021-04-02",
        "certification_date": "2021-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "6622P",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5014262",
            "primary": true
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "KY",
            "license": "3006622",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100140270",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinehurst, NC

Sources for this page

Verify at the official NPI Registry.