Individual provider Active NPI

Jordan Crowell

  • Nurse Practitioner
  • Chesapeake, VA
National Provider Identifier
1942050562
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
0024189496 Issued in VA
Practice address
710 Liberty St
Chesapeake, VA 23324-2637
Phone
(757) 917-5716
NPI assigned
Mar 26, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 0024189496 VA
Nurse Practitioner 363L00000X 0024189496 VA Primary

Addresses

Primary practice location

710 Liberty St
Chesapeake, VA 23324-2637

Mailing address

667 Kingsborough SQ Ste 101
Chesapeake, VA 23320-4999
Phone (801) 930-4362

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20240613001528 VA Practitioner - Nurse Practitioner 1850834243 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chesapeake Regional Medical GroupGroup PAC ID 8426113663, 148 clinicians

Practice addresses (Care Compare)

300 Medical Pkwy
Chesapeake, VA 23320-4985

710 Liberty St
Chesapeake, VA 23324-2637
Phone (757) 917-5716

Hospital & facility affiliations

  • Chesapeake General Hospital Hospital, Chesapeake, VA, CCN 490120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0024189496VAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Chesapeake Regional Medical Group CurrentSince Apr 1, 2024 Accepting new patients
Chesapeake Regional Medical Group CurrentSince Apr 1, 2024 Accepting new patients

Locations

300 Medical Pkwy
Chesapeake, VA 23320
Phone (757) 312-6102

710 Liberty St
Chesapeake, VA 23324
Phone (757) 543-6861

667 Kingsborough Sq
Ste 101
Chesapeake, VA 23320
Phone (757) 312-3132

Interoperability endpoints

  • Direct secure messaging: jordan.crowell.1@5072.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1711411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1942050562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "667 KINGSBOROUGH SQ STE 101",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233204999",
            "telephone_number": "801-930-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 LIBERTY ST",
            "city": "CHESAPEAKE",
            "state": "VA",
            "postal_code": "233242637",
            "telephone_number": "757-917-5716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWELL",
        "first_name": "JORDAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-26",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024189496",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024189496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesapeake, VA

Sources for this page

Verify at the official NPI Registry.