Kerry Bruce Jordan, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

04-24272 Issued in KS

Practice address

11301 Ash St
Leawood, KS 66211-1643

Phone

(913) 338-4515

Fax

(913) 338-4606

NPI assigned

Sep 25, 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 1

Medicare fee-for-service enrollment

Enrolled in KS

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

Specialty

Family Practice

Education

University of Kansas School of Med (KC/Wich/Sal), 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shawnee Mission Medical Center IncGroup PAC ID 9537119037, 282 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Shawnee Mission Hospital, Shawnee Mission, KS, CCN 170104

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kjordan1745798@adventhealth.direct-ci.com

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.

• Shawnee Mission Medical Center Inc

  • Family Medicine Physician
  • Merriam, KS
  • NPI 1992735690
  Medicare reassignment Care Compare group NPD
• Priority Care, LLC

  • Clinic/Center
  • Leawood, KS
  • NPI 1558452854
  NPD (past)

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

• Shawnee Mission Medical Center Inc

  • General Acute Care Hospital
  • Merriam, KS
  • NPI 1023171634
  Care Compare affiliation
• Shawnee Mission Medical Center Inc

  • Clinical Medical Laboratory
  • Merriam, KS
  • NPI 1235792003

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495670400000",
    "number": "1952401002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 412554",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641412554",
            "telephone_number": "913-338-4515",
            "fax_number": "913-338-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11301 ASH ST",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111643",
            "telephone_number": "913-338-4515",
            "fax_number": "913-338-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KERRY",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2017-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-24272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "BCBS OF KANSAS CITY",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Melissa M Journot, DPM
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• Jeffrey T Joyce, MD
• Julianna Ervin DDS
• Jordan Kabetske, DPT

• Family Medicine Physician in Leawood, KS
• Providers in Leawood, KS by specialty
• Family Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.