Individual provider Active NPI

Jordan Elizabeth Kantor

  • Medical Art Specialist/Technologist
  • Roanoke, VA
National Provider Identifier
1992292049
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Art Specialist/TechnologistTaxonomy code 246ZA2600X
License
1237000020 Issued in VA
Practice address
1114 4TH St SW
Roanoke, VA 24016-4208
Phone
(540) 588-4897
NPI assigned
Apr 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Art Specialist/Technologist 246ZA2600X 1237000020 VA Primary

Addresses

Primary practice location

1114 4TH St SW
Roanoke, VA 24016-4208

Mailing address

1114 4TH St SW
Roanoke, VA 24016-4208
Phone (540) 588-4897

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1237000020VAMDMedical Art Specialist/Technologist

NPI Registry JSON

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

{
    "created_epoch": "1523750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1992292049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1114 4TH ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164208",
            "telephone_number": "540-588-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1114 4TH ST SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240164208",
            "telephone_number": "540-588-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANTOR",
        "first_name": "JORDAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-15",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246ZA2600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": "VA",
            "license": "1237000020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.