Individual provider Active NPI

Jordan Paige Harrison, DO

  • Family Medicine Physician
  • Forrest City, AR
National Provider Identifier
1972180370
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
E-20061 Issued in AR
Practice address
904 Holiday Dr Ste 404
Forrest City, AR 72335-9157
Phone
(870) 261-0620
Fax
(870) 218-2115
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X E-20061 AR Primary
Family Medicine Physician 207Q00000X 5724 TN
Obstetrics Physician 207VX0000X 5724 TN
Obstetrics Physician 207VX0000X E-20061 AR
Family Medicine Physician 207Q00000X DO.3402 AL

Addresses

Primary practice location

904 Holiday Dr Ste 404
Forrest City, AR 72335-9157

Mailing address

904 Holiday Dr Ste 404
Forrest City, AR 72335-9157
Phone (870) 261-0620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, TN, AR3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20240708001130 AL Practitioner - Family Practice 9032513437 Reassigns benefits to 4 organizations
I20240812000863 TN Practitioner - Family Practice 9032513437 Reassigns benefits to 1 organization
I20260128000242 AR Practitioner - Family Practice 9032513437 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ut Medical Group IncGroup PAC ID 3173435369, 98 clinicians
Forrest City Clinic Company LLCGroup PAC ID 1557457447, 5 clinicians

Practice addresses (Care Compare)

1301 Primacy Pkwy
Memphis, TN 38119-0213
Phone (901) 448-0275

904 Holiday Dr
Suite 404
Forrest City, AR 72335-9157
Phone (870) 633-0215

Hospital & facility affiliations

  • Forrest City Medical Center Hospital, Forrest City, AR, CCN 040019

Merit-based Incentive Payment System (MIPS)

Final score
88.15 of 100Reported as group
Quality
59.97
Promoting interoperability
100
Improvement activities
40
Cost
80.93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5724TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gmuc of Springhill LLC Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Greater Mobile Urgent Care Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Ut Medical Group Inc Family Medicine CurrentSince Aug 1, 2024 Accepting new patients
Ut Medical Group, Inc. CurrentSince Aug 1, 2024 Accepting new patients
Gmuc of Citronelle LLC Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Gmuc of Saraland Family Medicine CurrentSince Jun 1, 2024 Accepting new patients
Forrest City Clinic Company LLC CurrentSince Jan 1, 2026 Accepting new patients
Greater Mobile Urgent Care Family Medicine CurrentSince Jun 1, 2024 Accepting new patients

Locations

19355 N 3rd St
Ste 104
Citronelle, AL 36522
Phone (251) 633-0123

2350 Schillinger Rd S
Ste A
Mobile, AL 36695
Phone (251) 633-0123

4402 Old Shell Rd
Mobile, AL 36608
Phone (251) 633-0123

1114 Shelton Beach Rd
Saraland, AL 36571
Phone (251) 633-0123

7943 Moffett Rd
Semmes, AL 36575
Phone (251) 445-7618

1601 New Castle Rd
Forrest City, AR 72335
Phone (870) 261-0000

904 Holiday Dr
Ste 402
Forrest City, AR 72335
Phone (870) 633-6000

904 Holiday Dr
Ste 404
Forrest City, AR 72335
Phone (870) 630-1683

1301 Primacy Pkwy
Memphis, TN 38119
Phone (901) 448-0230

930 Madison Ave
Ste 200
Memphis, TN 38103
Phone (901) 448-6650

1068 Cresthaven Rd
Ste 300
Memphis, TN 38119
Phone (901) 683-0024

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/1607/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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 1

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": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1972180370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 HOLIDAY DR STE 404",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723359157",
            "telephone_number": "870-261-0620",
            "fax_number": "870-218-2115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 HOLIDAY DR STE 404",
            "city": "FORREST CITY",
            "state": "AR",
            "postal_code": "723359157",
            "telephone_number": "870-261-0620",
            "fax_number": "870-218-2115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "JORDAN",
        "middle_name": "PAIGE",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "E-20061",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "5724",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "TN",
            "license": "5724",
            "primary": false
        },
        {
            "code": "207VX0000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "AR",
            "license": "E-20061",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "DO.3402",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forrest City, AR

Sources for this page

Verify at the official NPI Registry.