MR. CHARLES RAYMOND JORDAN (NPI# 1306126263) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306126263 |
| Entity Type | Individual |
| Full Name | MR. CHARLES RAYMOND JORDAN |
| Credential | FNP |
| Practice Address |
1350 Sunset Dr Ste B Grenada MS 38901-4079 |
| Mailing Address |
Po Box 395 N.carrollton MS 38947-0395 |
| Practice Telephone | 6624663632 |
| Mailing Telephone | 6624663632 |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R869908 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508477910 | Charles B. Jordan | Technician | 1339 Fairview Rd, Webster Springs, WV 26288-8444 | 2020-08-11 |
| 1568561462 | Charles E Jordan | Orthopaedic Surgery | 751 Pre Emption Rd, Suite 1, Geneva, NY 14456 | 2006-09-21 |
| 1871565374 | Charles J Jordan | Dentist | 1425 W Grand Ave Ste 101, Haysville, KS 67060-1270 | 2006-02-07 |
| 1518516392 | Charles Jordan | Dentist | 412 Northside Dr E, Statesboro, GA 30458-4802 | 2019-09-05 |
| 1932752110 | Charles Jordan | Counselor | 222 Tongass Dr, Sitka, AK 99835-9416 | 2019-07-17 |
| 1679033476 | Charles Jordan | Nurse Practitioner | 10201 Highway 16, Comanche, TX 76442-4462 | 2019-03-20 |
| 1578060794 | Charles Jordan | Counselor | 4124 Linden Ave, Dayton, OH 45432-3018 | 2018-04-13 |
| 1205340890 | Charles Jordan | Physical Therapist | 2699 Wehrle Dr, Williamsville, NY 14221-7332 | 2017-11-20 |
| 1386168334 | Charles Jermaine Jordan | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Building 301, Andrews Avenue, Fort Rucker, AL 36362-5333 | 2017-08-01 |
| 1013295120 | Charles R Jordan | Pharmacist | 13111 W Alameda Pkwy, Lakewood, CO 80228-3108 | 2011-07-25 |
| Street Address |
1350 SUNSET DR STE B |
| City | GRENADA |
| State | MS |
| Zip Code | 38901-4079 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902435118 | The Mane Physician | Prosthetic/Orthotic Supplier | 94 Spain Drive, Grenada, MS 38901 | 2020-04-08 |
| 1942842166 | Sylvia C Bass | Technician | 813 Union Street, Grenada, MS 38901 | 2019-10-09 |
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1073912762 | John Thomas Mcree I | Counselor | 2026 Commerce St Ste 8e, Grenada, MS 38901 | 2014-08-19 |
| 1700213634 | State of Mississippi-university of Mississippi Medical Center | Home Health | 960 Avent Drive, Grenada, MS 38901 | 2013-10-10 |
| 1114359866 | Cmhp Enterprises | Dentist | 1420 Wooded Drive, Grenada, MS 38901 | 2013-08-05 |
| 1518256460 | Mercy Hospice LLC | Hospice Care, Community Based | 1410 Wooded Drive, Grenada, MS 38901 | 2011-03-31 |
| 1215256318 | Della Lea Welsh | Speech-Language Pathologist | 1321 Dd Sunset Dr., Grenada, MS 38901 | 2010-05-28 |
| 1750514543 | Family Health Care Clinic, Inc. | Clinic/Center | 1102 Telegraph St, Grenada, MS 38901 | 2009-08-27 |
| 1033384771 | Jason K Bennett | Pharmacist | 140 Shadow Wood Cv, Grenada, MS 38901 | 2008-04-24 |
| Find all providers in zip 38901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669971180 | Jenny Taylor | Nurse Practitioner | 350 Sunset Drive, Grenada, MS 38901 | 2018-02-10 |
| 1144400607 | Family Health Clinic of Grenada | Nurse Practitioner | 1117 Sunset Dr Ste 104, Grenada, MS 38901-4080 | 2007-11-13 |
| 1194947754 | Shonda Jacqueline Phelon | Nurse Practitioner | 1970 Grandview Dr, Grenada, MS 38901-5066 | 2007-05-03 |
| 1629103510 | Sandra Flint Melton | Nurse Practitioner | 1241 S Mound St Ste A, Grenada, MS 38901-4515 | 2007-02-22 |
| 1619987427 | Debbie Elizabeth Mcgehee | Nurse Practitioner | 100 East Monroe Street, Grenada, MS 38901-4080 | 2006-08-08 |
| 1720057565 | Cynthia C Dotson | Nurse Practitioner | 965 Avent Dr Ste 105, Grenada, MS 38901-5045 | 2006-03-15 |
| 1841299500 | Nell Catherine Brock | Nurse Practitioner | 108 Vfw Rd, Grenada, MS 38901 | 2005-07-15 |
| 1013515980 | Aarrin Marie Mcdougal | Nurse Practitioner | 100 E Monroe St, Grenada, MS 38901-5249 | 2020-10-13 |
| 1205441375 | Alison Campbell | Nurse Practitioner | 1117 Sunset Dr Ste 104, Grenada, MS 38901-4080 | 2020-09-15 |
| 1275158776 | Childrens Health Clinic | Nurse Practitioner | 340 Van Dorn St, Grenada, MS 38901-4738 | 2020-06-10 |
| Find all providers in GRENADA | ||||
Please comment or provide details below to improve the information on MR. CHARLES RAYMOND JORDAN.
| 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.