MR. JORDAN A BLEECKER


Address: 2300 Maccorkle Ave Se, Charleston, WV 25304-1045
Phone: 2043574710

MR. JORDAN A BLEECKER (NPI# 1154898062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154898062
Entity Type Individual
Full Name MR. JORDAN A BLEECKER
Credential PA-S
Practice Address 2300 Maccorkle Ave Se
Charleston
WV 25304-1045
Mailing Address 1021 Wilkie Dr # 2
Charleston
WV 25314-1722
Practice Telephone 2043574710
Mailing Telephone 8054507619
Enumeration Date 2018-10-29
Last Update Date 2018-10-29
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 390200000X Student in an Organized Health Care Education/Training Program Student, Health Care

Provider Secondary Practice Location

Address Telephone Number Fax Number
2300 Maccorkle Ave Se, Charleston, WV 253041045 2043574710

Office Location

Street Address 2300 MACCORKLE AVE SE
City CHARLESTON
State WV
Zip Code 25304-1045

Providers in the same location

NPI Name Taxonomy Address Enumeration
1659363950 Laura P Welch Pharmacist 2300 Maccorkle Ave Se, University of Charleston School of Pharmacy, Charleston, WV 25304-1045 2005-08-22
1235787664 Rebekah Coleen Warrington Specialist/Technologist 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2019-08-28
1396203519 Chloe Nellie Massaro Specialist/Technologist 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2019-03-06
1649737818 Alfonso Jose Davila Davila Specialist/Technologist 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2019-02-25
1720552946 Jacob David Winkle Specialist/Technologist 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2019-01-22
1689148884 Siarra Harringtn Student in an Organized Health Care Education/Training Program 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2019-01-22
1497219646 Allie Robinson Student in an Organized Health Care Education/Training Program 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2019-01-22
1083150437 Kenji Ueda Specialist/Technologist 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2017-01-10
1922541564 Jennifer M Barley Pharmacist 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2016-11-30
1124475652 Alex Stratton Student in an Organized Health Care Education/Training Program 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 2016-05-13
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1740893908 Sade Yvonne Rice Technician 392 B South Parkd Rd, Charleston, WV 25304 2020-08-27
1053931410 Pir Ali Shah Student in an Organized Health Care Education/Training Program 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 2020-04-25
1649807603 Jasmine Shah Student in an Organized Health Care Education/Training Program 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 2020-03-26
1447811872 Kwasi Amponsah Gambrah Student in an Organized Health Care Education/Training Program 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 2019-06-26
1457916751 Divya Kalluru Student in an Organized Health Care Education/Training Program 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 2019-05-02
1841854965 Sean Michael Percy Losier Student in an Organized Health Care Education/Training Program 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 2019-04-24
1700440047 Priyanka Chowdhry Student in an Organized Health Care Education/Training Program Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 2019-04-23
1568925469 Saranya Dinesan Student in an Organized Health Care Education/Training Program 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 2019-04-09
1043771694 Mary Elizabeth Novak Student in an Organized Health Care Education/Training Program Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 2019-03-27
1124518600 Abdullah Sohail Student in an Organized Health Care Education/Training Program 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 2018-05-10
Find all providers in zip 25304

Taxonomy Information

Taxonomy Code 390200000X
Grouping Student, Health Care
Classification Student in an Organized Health Care Education/Training Program

Taxonomy Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
Notes: [1/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144833823 Shadi Adib Bashai Student in an Organized Health Care Education/Training Program 743 1/2 Washington St W, Charleston, WV 25302-1844 2020-08-24
1043837883 Jacey Renee Dillon Student in an Organized Health Care Education/Training Program 2119 Stoner Dr W, Charleston, IL 61920-3723 2020-06-27
1053931410 Pir Ali Shah Student in an Organized Health Care Education/Training Program 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 2020-04-25
1629698865 Umer Muhammad Student in an Organized Health Care Education/Training Program Childrens Medicine Center, 800 Pennsylvania Ave, Charleston, WV 25302 2020-04-17
1730718891 Ryan Metts Student in an Organized Health Care Education/Training Program 211 Ashley Ave Apt B, Charleston, SC 29403-6859 2020-04-02
1598393506 Khadija Naseem Student in an Organized Health Care Education/Training Program Robert C. Bird Clinical Training Center, 3200 Maccorkle Avenue Southeast, Charleston, WV 25304-1208 2020-03-27
1235766411 Abhishek Yadav Student in an Organized Health Care Education/Training Program 101 29th St Se Apt 20, Charleston, WV 25304-1149 2020-03-26
1649807603 Jasmine Shah Student in an Organized Health Care Education/Training Program 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 2020-03-26
1861027815 Robert Bryce Robbins Student in an Organized Health Care Education/Training Program Search Results 171 Ashley Ave, Charleston, SC 29425-0001 2020-03-10
1700426343 Mikaela Kiser Student in an Organized Health Care Education/Training Program 3813 Staunton Ave Se Unit A, Charleston, WV 25304-1537 2020-01-12
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Competitor

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City CHARLESTON
Zip Code 25304

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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