Adrienne C Jordan, M.D

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

35.129358 Issued in OH

Practice address

7835 Paragon Rd
Dayton, OH 45459-4021

Phone

(800) 532-3232

NPI assigned

Mar 22, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in MI, IN, WV, NC4 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 4

Specialty

Pathology

Education

Northeastern Ohio University College of Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Metrolina Dermatology and Skin Surgery Specialists PLLCGroup PAC ID 3173891892, 39 clinicians

Legacy Path LLCGroup PAC ID 5890237960, 16 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Legacy Path LLC

  • Anatomic Pathology & Clinical Pathology Physician
  • South Bend, IN
  • NPI 1205693728

  MI

  Medicare reassignment Care Compare group NPD
• Metrolina Dermatology and Skin Surgery Specialists, PLLC

  • Dermatology Physician
  • Charlotte, NC
  • NPI 1619400033
  Medicare reassignment Care Compare group NPD
• Mountain State Medical Specialties, PLLC

  • Dermatology Physician
  • Bridgeport, WV
  • NPI 1891892097
  Medicare reassignment NPD
• South Bend Medical Foundation, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • South Bend, IN
  • NPI 1649241084
  Medicare reassignment NPD
• South Bend Medical Foundation, Inc

  • Anatomic Pathology & Clinical Pathology Physician
  • South Bend, IN
  • NPI 1922623305

  MI

  Medicare reassignment NPD
• Dermatopathology Laboratory of Central States

  • Clinical Medical Laboratory
  • Dayton, OH
  • NPI 1912914144
  NPD (past)

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

{
    "created_epoch": "1237680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738800000000",
    "number": "1982845921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7835 PARAGON RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594021",
            "telephone_number": "800-532-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7835 PARAGON RD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454594021",
            "telephone_number": "800-532-3232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "530 S Jackson St",
            "address_purpose": "LOCATION",
            "city": "Louisville",
            "state": "KY",
            "postal_code": "402021675",
            "country_code": "US",
            "telephone_number": "502-852-6395",
            "fax_number": "502-852-1761",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3355 Douglas Rd",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466351779",
            "country_code": "US",
            "telephone_number": "574-234-4176",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "ADRIENNE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-22",
        "last_updated": "2025-02-06",
        "certification_date": "2025-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IN",
            "license": "01093970A",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MI",
            "license": "EMC0005318",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "276650",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "KY",
            "license": "TP893",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WV",
            "license": "29457",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "35.129358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracey Ann Jones, LPN
• Vickie Jones, RN
• Zachary Jones, PHARMD.
• Patricia Mae Joness, LPN
• Alisha Jordan-Murray, LISW
• Angela Jordan
• Anthony Jordan
• Ashley Jordan
• Blakley E Jordan, APRN
• Bryce Jordan, RD

• Anatomic Pathology & Clinical Pathology Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• Anatomic Pathology & Clinical Pathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2025; 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.