Manley McRae Jordan, MD

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

017837 Issued in LA

Practice address

2770 3Rd Ave
Suite 110
Lake Charles, LA 70601-8994

Phone

(337) 494-2750

Fax

(337) 494-2760

NPI assigned

Aug 5, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/d924d991-43c4-4c48-b322-4525ba4c2001/

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.

• LCMS Pulmonary Associates of Southwest Louisiana

  • Pulmonary Disease Physician
  • Lake Charles, LA
  • NPI 1508175704
  Medicare reassignment NPD
• Lake Charles Pharmaceutical Supply Company LLC

  • Community/Retail Pharmacy
  • Lake Charles, LA
  • NPI 1750446183
  NPD
• Southwest Louisiana Hospital Association Inc

  • Gastroenterology Physician
  • Lake Charles, LA
  • NPI 1285351411
  NPD (past)
• East Tennessee Pulmonary Associates PC

  • Pulmonary Disease Physician
  • Oak Ridge, TN
  • NPI 1992717599
  NPD (past)
• Methodist Medical Center

  • General Acute Care Hospital
  • Oak Ridge, TN
  • NPI 1700870672
  NPD (past)
• Statcare Outpatient, LLC

  • Pulmonary Disease Physician
  • Knoxville, TN
  • NPI 1134653892
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449014400000",
    "number": "1932118296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 122309",
            "address_2": "DEPT 2309",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753122309",
            "telephone_number": "337-494-2919",
            "fax_number": "337-494-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 3RD AVE",
            "address_2": "SUITE 110",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018994",
            "telephone_number": "337-494-2750",
            "fax_number": "337-494-2760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MANLEY",
        "middle_name": "MCRAE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2015-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "LA",
            "license": "017837",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00221352",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1468444",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roy Lee Jones
• Susan A. Jones, MD
• Terrilyn Jones
• Alexander Scott Jordan, PA-C
• Andrew Jordan
• Renee S Jordan, MASTERS IN EDUCATION
• Joseph a Livergood, DC, LLC
• Aleya Joseph
• Delicia Joseph
• Hannah Joseph, DPT

• Pulmonary Disease Physician in Lake Charles, LA
• Providers in Lake Charles, LA by specialty
• Pulmonary Disease Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.