Marshall C Jordan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD2006-0824 Issued in NM

Practice address

Espanola Multi-Specialty Clinic
1010 Spruce St
Espanola, NM 87532

Phone

(505) 367-0340

Fax

(505) 367-0346

NPI assigned

May 17, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Mwa, PC

  • Sleep Disorder Diagnostic Clinic/Center
  • Chicopee, MA
  • NPI 1427280791
  NPD (past)
• Riverbend Medical Group, Inc

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1639280779
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218672000000",
    "number": "1982656880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 26666",
            "address_2": "PHS PROVIDER ENROLLMENT",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871256666",
            "telephone_number": "505-923-5356",
            "fax_number": "505-923-5354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ESPANOLA MULTI-SPECIALTY CLINIC",
            "address_2": "1010 SPRUCE ST",
            "city": "ESPANOLA",
            "state": "NM",
            "postal_code": "87532",
            "telephone_number": "505-367-0340",
            "fax_number": "505-367-0346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "MARSHALL",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2008-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NM",
            "license": "MD2006-0824",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "29377056",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Morgan Leigh Johnson, MPAS, PA-C
• Simon M Johnson, BMS
• Carrie Elizabeth Jones, MD
• Jordan E Jones, DO
• Steven D Jones, D.O.
• Brent Lee Jorgensen
• Kimberly Ann Joy, FNP
• Gretchen Kaapcke, LMT
• Sara Lisa Kaminski, MAC,MAT,MSP,NCPM
• Gary Kanner, MD

• Surgery Physician in Espanola, NM
• Providers in Espanola, NM by specialty
• Surgery Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.