KENNETH WAYNE JORDAN (NPI# 1184628505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184628505 |
| Entity Type | Individual |
| Full Name | KENNETH WAYNE JORDAN |
| Credential | MD |
| Practice Address |
2100 Erwin Rd Durham NC 27705-3941 |
| Practice Telephone | 9196848111 |
| Mailing Telephone | 9196848111 |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2009-09-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 33260 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 8947445 | 05 | |
| NC | BJ1675531 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801935044 | Kenneth Michael Jordan | Radiologic Technologist | 4201 E Loop 820 S, Ste C, Ft Worth, TX 76119-4443 | 2007-02-05 |
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1235186438 | Kenneth A Jordan | Internal Medicine | 295 Maple St Ste 202, Tawas City, MI 48763-9352 | 2006-05-31 |
| 1902867252 | Kenneth Wesley Jordan | Chiropractor | 705 North Fraser St, Georgetown, SC 29442-0958 | 2006-03-28 |
| 1477537116 | Kenneth George Jordan | Specialist | 1660 Plum Ln, Redlands, CA 92374-4532 | 2005-12-06 |
| 1366049900 | Kenneth Bernard Jordan | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-10-06 |
| 1285278580 | Kenneth Warren Jordan | Speech-Language Pathologist | 2600 Compass Rd, Glenview, IL 60026-8001 | 2019-10-30 |
| 1548739147 | Kenneth Jordan | Counselor | 1700 Airport Way S, Seattle, WA 98134-1618 | 2018-11-13 |
| 1386122141 | Kenneth Jordan | Social Worker | 29 Maple St, Littleton, NH 03561 | 2018-08-03 |
| 1932440385 | Kenneth W Jordan | Pharmacist | 701 E Milam St, Mexia, TX 76667-2445 | 2013-03-11 |
| Street Address |
2100 ERWIN RD |
| City | DURHAM |
| State | NC |
| Zip Code | 27705-3941 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215930417 | Raymond C Barfield | Pediatrics | 2100 Erwin Rd, Durham, NC 27710-0001 | 2005-05-23 |
| 1477058584 | Natalie Louise Tammen | Physician Assistant | 2100 Erwin Rd, Durham, NC 27705-3941 | 2018-03-29 |
| 1205350691 | Deema Elchoufi | Student in an Organized Health Care Education/Training Program | 2100 Erwin Rd, Durham, NC 27705-3941 | 2017-07-28 |
| 1164965372 | Duke Family Medicine | Preferred Provider Organization | 2100 Erwin Rd, Durham, NC 27705-3941 | 2016-11-21 |
| 1306391560 | Jesslyn Patrice Doody | Physician Assistant | 2100 Erwin Rd, Durham, NC 27705-3941 | 2016-08-17 |
| 1134579147 | Tyler Henderson Knowles | Nurse Anesthetist, Certified Registered | 2100 Erwin Rd, Durham, NC 27705-3941 | 2016-06-21 |
| 1962852665 | David Tallon | Nurse Practitioner | 2100 Erwin Rd, Durham, NC 27705-3941 | 2016-06-14 |
| 1780079608 | Jeanna J Bateson | Physician Assistant | 2100 Erwin Rd, Durham, NC 27705 | 2015-03-30 |
| 1184034431 | Walter F Wiggins | Radiology | 2100 Erwin Rd, Durham, NC 27705-3941 | 2014-05-07 |
| 1629499108 | Joshua Harris | Social Worker | 2100 Erwin Rd, Durham, NC 27705-3941 | 2013-12-30 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371755 | Tyler Beach, Lcsw, Pllc | Social Worker | 2740 Spencer Street, Durham, NC 27705 | 2019-11-20 |
| 1720635477 | Brittany W Fry | Registered Nurse | 2301 Erwin Road, Hafs Building, Room 6670, Durham, NC 27705 | 2019-08-19 |
| 1760968044 | Nicole D Moore | Social Worker | 1921 N. Pointe Dr, Suite 280, Durham, NC 27705 | 2018-07-19 |
| 1144757097 | Emileigh S Dowling | Physical Therapist | 3475 Erwin Rd Bldg 2, Durham, NC 27705 | 2017-05-22 |
| 1487195350 | Daniel Lynch | Physical Therapist | 3475 Erwin Road, Pepsico Building, Durham, NC 27705 | 2017-03-13 |
| 1780131839 | Michael A Fitzpatrick Iv | Physical Therapist | 3475 Erwin Rd Bldg 2nd, Durham, NC 27705 | 2016-09-07 |
| 1609241736 | Julia Power Constant | Physician Assistant | Dumc Box 3913, Durham, NC 27705 | 2015-12-01 |
| 1518344159 | Amanda Clark Coniglio | Internal Medicine | 2301 Erwin Rd # 3845, Durham, NC 27705 | 2015-05-04 |
| 1720486988 | Jennifer Dawn Pace | Physician Assistant | 1821 Hillandale Road Suite 24a, Duke Urgent Care, Durham, NC 27705 | 2014-12-19 |
| 1942612106 | Rachel Hibberd | Psychologist | 508 Fulton Avenue, Durham Va Medical Center, Durham, NC 27705 | 2014-05-22 |
| Find all providers in zip 27705 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609294743 | Joanna Maria Robles | Pediatrics | 382 Hanes Building Dumc Box 102382, Durham, NC 27710 | 2014-04-05 |
| 1437577814 | Eunee Kathleen Park | Pediatrics | 4806 Carmen Ln, Durham, NC 27707-9080 | 2014-04-02 |
| 1821416652 | Lashawndra Sly Walker | Pediatrics | 2424 Hock Plaza Suite 504, Durham, NC 27710-1005 | 2014-03-29 |
| 1316385982 | Lorven Michael Edralin | Pediatrics | 1821 Hillandale Rd Ste 24a, Durham, NC 27705-2671 | 2013-06-05 |
| 1245597178 | Ibukunoluwa Christine Akinboyo | Pediatrics | 2301 Erwin Rd # Dumc3499, Durham, NC 27705 | 2012-04-17 |
| 1851667380 | Tavia Denise Clark | Pediatrics | 7 Kerr Ct, Durham, NC 27713-8919 | 2012-03-29 |
| 1295021483 | Camille Nina Immanuel | Pediatrics | 4100 Cobscook Dr, Durham, NC 27707-5706 | 2011-06-26 |
| 1922391473 | Stephanie Permar Schwartz | Pediatrics | 5260y Duke N, Dumc Box 3046, Durham, NC 27710-0001 | 2011-05-17 |
| 1700100575 | Yeh-chung Chang | Pediatrics | 2301 Erwin Road Dumc 3499, Durham, NC 27710-4319 | 2010-03-22 |
| 1790018000 | Muhammad Shahzad Zafar | Pediatrics | Dumc 102350, Duke Medical Center, Durham, NC 27710-0001 | 2009-09-18 |
| Find all providers in DURHAM | ||||
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| 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.