Jeremiah Jordan
Individual provider Active NPI School Psychologist · Stanardsville, VA
NPI 1972079846 · NPPES record last updated Oct 18, 2018
Key facts
- NPI
- 1972079846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Psychologist 103TS0200X
- Practice address
- 8094 Spotswood TRL
Stanardsville, VA 22973-2846 - Phone
- (434) 939-9001
- NPI assigned
- Oct 18, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | Yes |
Addresses
Primary practice location
8094 Spotswood TRL
Stanardsville, VA 22973-2846
Mailing address
8094 Spotswood TRL
Stanardsville, VA 22973-2846
Phone (434) 939-9001
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0813000755 | Medicaid | VA |
Other providers in Stanardsville, VA
- Greene County Rescue Squad
- HP / Stanardsville, Inc.
- HP/Standardsville, Inc.
- HP/Standardsville, Inc.
- Howard Dana Jadofsky
- Andrew T Kelly
- Donald Aubrey Knight
- Shawn McQueen
- Renee Elizabeth Mish
- Wister Mitchelson
All providers in Stanardsville, VA · School Psychologist in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.