Individual provider Active NPI

Jordan R. King, AU.D.

  • Audiologist
  • Allen, TX
National Provider Identifier
1962180141
Registry record updated Jul 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
81643 Issued in TX
Practice address
1780 W McDermott Dr Ste 200
Allen, TX 75013-3363
Phone
(972) 733-3344
Fax
(972) 733-3852
NPI assigned
Jul 7, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 81643 TX Primary
Audiologist-Hearing Aid Fitter 237600000X 81643 TX

Addresses

Primary practice location

1780 W McDermott Dr Ste 200
Allen, TX 75013-3363

Mailing address

1780 W McDermott Dr Ste 200
Allen, TX 75013-3363
Phone (972) 733-3344

Other names 1

  • Jordan Lindley Russell Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230727001542 TX Practitioner - Qualified Audiologist 3577924257 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
University of Tennessee, HSC, College of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Hearing Center, LLCGroup PAC ID 4880912419, 2 clinicians

Practice addresses (Care Compare)

1780 W McDermott Dr
Suite 200
Allen, TX 75013-3363
Phone (972) 733-3344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81643TXMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Hearing Center, LLC Audiologist CurrentSince Jun 15, 2023 Accepting new patients

Locations

1780 W McDermott Dr
Ste 200
Allen, TX 75013
Phone (972) 733-3344

1340 S Main St
Ste 195
Grapevine, TX 76051
Phone (972) 733-3344

Organizations & group practices 1

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": "1688688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688688000000",
    "number": "1962180141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1780 W MCDERMOTT DR STE 200",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133363",
            "telephone_number": "972-733-3344",
            "fax_number": "972-733-3852"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1780 W MCDERMOTT DR STE 200",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750133363",
            "telephone_number": "972-733-3344",
            "fax_number": "972-733-3852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KING",
        "first_name": "JORDAN",
        "middle_name": "R.",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-07",
        "last_updated": "2023-07-07",
        "certification_date": "2023-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "TX",
            "license": "81643",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "TX",
            "license": "81643",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JORDAN",
            "last_name": "RUSSELL",
            "middle_name": "LINDLEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Allen, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.