Individual provider Active NPI

Susan Anne Jordan, M.D.

  • Family Medicine Physician
  • Melbourne, AR
National Provider Identifier
1952361776
Registry record updated May 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E4534 Issued in AR
Practice address
1526 E. Main Street
Melbourne, AR 72556
Phone
(870) 368-4344
Fax
(870) 368-3051
NPI assigned
Mar 24, 2006
Last updated
May 1, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E4534 AR Primary

Addresses

Primary practice location

1526 E. Main Street
Melbourne, AR 72556

Mailing address

1526 E. Main Street
Melbourne, AR 72556
Phone (870) 368-4344

Other identifiers 1

IdentifierTypeStateIssuer
159002001MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20120912000144 AL Practitioner - Family Practice 3779515671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Georgia School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
American Family Care, LLCGroup PAC ID 9739087818, 180 clinicians

Practice addresses (Care Compare)

8151 Whitesburg Dr SE
Huntsville, AL 35802-4557
Phone (256) 882-9711

Merit-based Incentive Payment System (MIPS)

Final score
70.43 of 100Reported as group
Quality
65.59
Improvement activities
40
Cost
64.54

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
E4534ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Family Care, LLC Family Medicine CurrentSince Aug 15, 2012 Accepting new patients
American Family Care, LLC CurrentSince Aug 15, 2012 Accepting new patients
American Family Care, LLC Current Accepting new patients
CHI St. Vincent Medical Group Hot Springs Family Medicine PastSince Aug 1, 2011 Accepting new patients

Locations

2147 Riverchase Office Rd
Hoover, AL 35244
Phone (205) 403-8902

8151 Whitesburg Dr SE
Huntsville, AL 35802
Phone (256) 882-9711

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335830400000",
    "number": "1952361776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1526 E. MAIN STREET",
            "city": "MELBOURNE",
            "state": "AR",
            "postal_code": "72556",
            "telephone_number": "870-368-4344",
            "fax_number": "870-368-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1526 E. MAIN STREET",
            "city": "MELBOURNE",
            "state": "AR",
            "postal_code": "72556",
            "telephone_number": "870-368-4344",
            "fax_number": "870-368-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "SUSAN",
        "middle_name": "ANNE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-24",
        "last_updated": "2012-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E4534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159002001",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, AR

Sources for this page

Verify at the official NPI Registry.