Katelyn Wells Jordan, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

OPC4759 Issued in FL

Practice address

3901 University Blvd S
Suite 103
Jacksonville, FL 32216-4312

Phone

(904) 389-9989

Fax

(904) 389-1060

NPI assigned

Aug 29, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Katelyn Louise Wells Former name

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

University of Houston - College of Optometry, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physical Medicine Specialists, IncGroup PAC ID 1658335328, 60 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Brooks Rehabilitation Hospital University Campus Inpatient rehabilitation facility, Jacksonville, FL, CCN 103039

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Quality

100

Promoting interoperability

99

Improvement activities

40

Cost

85.3

Medicare enrollment (NPD)

Enrolled

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.

• Physical Medicine Specialists, Inc.

  • Physical Medicine & Rehabilitation Physician
  • Jacksonville, FL
  • NPI 1952343261
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1376114413

  Inpatient rehabilitation facility

  Care Compare affiliation
• Genesis Rehabilitation Hospital, Inc.

  • Rehabilitation Hospital
  • Jacksonville, FL
  • NPI 1912947748

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401667200000",
    "number": "1982952537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-389-9989",
            "fax_number": "904-389-1060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 UNIVERSITY BLVD S",
            "address_2": "SUITE 103",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322164312",
            "telephone_number": "904-389-9989",
            "fax_number": "904-389-1060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JORDAN",
        "first_name": "KATELYN",
        "middle_name": "WELLS",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-29",
        "last_updated": "2014-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1723",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "FL",
            "license": "OPC4759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATELYN",
            "last_name": "WELLS",
            "middle_name": "LOUISE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jada Jordan
• Jada Jordan, PTA
• James Jordan, MD
• Joyce Delores Jordan, B.S.
• Kalyn W. Jordan, APRN
• Lisa Jordan, LCSW
• Lisa Jordan
• Melissa B Jordan, A.P., DAHM, DIPL OM
• Patrinya Jordan
• Quinton L Jordan

• Optometrist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Optometrist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2014; 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.