CHARLES JERMAINE JORDAN (NPI# 1386168334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386168334 |
| Entity Type | Individual |
| Full Name | CHARLES JERMAINE JORDAN |
| Credential | NREMT |
| Practice Address |
Lyster Army Health Clinic Building 301, Andrews Avenue Fort Rucker AL 36362-5333 |
| Practice Telephone | (334) 255-7603 |
| Mailing Telephone | 3342557603 |
| Enumeration Date | 2017-08-01 |
| Last Update Date | 2017-08-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 146N00000X | Emergency Medical Technician, Basic | E1485589 | TX | Emergency Medical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508477910 | Charles B. Jordan | Technician | 1339 Fairview Rd, Webster Springs, WV 26288-8444 | 2020-08-11 |
| 1306126263 | Charles Raymond Jordan | Nurse Practitioner | 1350 Sunset Dr Ste B, Grenada, MS 38901-4079 | 2011-08-24 |
| 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 |
| 1013295120 | Charles R Jordan | Pharmacist | 13111 W Alameda Pkwy, Lakewood, CO 80228-3108 | 2011-07-25 |
| Street Address |
LYSTER ARMY HEALTH CLINIC BUILDING 301, ANDREWS AVENUE |
| City | FORT RUCKER |
| State | AL |
| Zip Code | 36362-5333 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912964115 | Wendy Ruth Campbell | Nurse Practitioner | Lyster Army Health Clinic, 301 Andrews Avenue, Fort Rucker, AL 36362 | 2006-05-01 |
| 1598311409 | Catherine Rebecca Baden | Technician | Lyster Army Health Clinic, Bldg 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-08-15 |
| 1447802392 | Ginger Lynn Tanner | Registered Nurse | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1659923506 | Joni E Prugh | Physical Therapy Assistant | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-11 |
| 1063074805 | Crystal Harris | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-07-02 |
| 1871158444 | Dorma Sanders | Registered Nurse | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-05-08 |
| 1942769047 | Emily Sue Canlas | Registered Nurse | Lyster Army Health Clinic, Bldg. 301 Andrews Ave., Fort Rucker, AL 36362-5333 | 2019-03-18 |
| 1366900821 | Michael Joseph Brown | Emergency Medical Technician, Basic | Lyster Army Health Clinic, Building 301 Andrews Avenue, Fort Rucker, AL 36362-5333 | 2019-03-04 |
| 1861956823 | Katherine Lambeth | Technician/Technologist | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2019-01-24 |
| 1376014480 | Patrick Gabriel Lawson | Emergency Medical Technician, Paramedic | Lyster Army Health Clinic, Bldg 301 Andrews Ave, Fort Rucker, AL 36362-5333 | 2018-12-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745571 | Rachel Kestler | Specialist | 4102 Gadiator Street, Fort Rucker, AL 36362 | 2020-09-22 |
| 1417589268 | Jacob Michael Lezon | Emergency Medical Technician, Basic | 30501 Nevins St., Ft. Rucker, AL 36362 | 2020-02-10 |
| 1225535388 | Rhonda Lewis Wesolek | Dental Hygienist | Bldg 4405, Innkeeper Street, Fort Rucker, AL 36362 | 2018-04-06 |
| 1770013369 | National Vision, Inc. | Technician/Technologist | Bldg 9214, Fort Rucker, AL 36362 | 2017-06-15 |
| 1750730958 | Teresa Morgan Knighten | Dental Hygienist | 4405 Innkeepers St, Fort Rucker, AL 36362 | 2016-06-08 |
| 1568826246 | David Virgil II | Technician, Other | 2218 6th Avenue Building 4102, Fort Rucker, AL 36362 | 2016-04-08 |
| 1356771257 | Robert E Smith | Emergency Medical Technician, Intermediate | Blding 301 Andrew Ave, Ft Rucker, AL 36362 | 2013-11-14 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1689913808 | Sunland Optical Co., Inc. | Eyewear Supplier (Equipment, not the service) | Fort Rucker Bldg. 9214, Daleville, AL 36362 | 2013-02-07 |
| 1275880205 | Sandra Lynn Griffin Banner | Optometrist | 33 Endl Ave, Fort Rucker, AL 36362 | 2012-08-09 |
| Find all providers in zip 36362 | ||||
| Taxonomy Code | 146N00000X |
| Grouping | Emergency Medical Service Providers |
| Classification | Emergency Medical Technician, Basic |
| A Basic EMT is an individual trained and certified to perform basic life support treatment in medical emergencies based on individual state boards. |
| Notes: Sources: Tabers Medical Dictionary and Florida EMS Clearing House. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902440514 | Aaron William Laube | Emergency Medical Technician, Basic | 28 Galt Ln, Fort Rucker, AL 36362-2304 | 2019-11-06 |
| 1659812733 | Rebecka Nisbet | Emergency Medical Technician, Basic | Andrews Avenue Building 301, Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2017-03-09 |
| 1720493620 | Nathan Kennedy | Emergency Medical Technician, Basic | 8350 3rd Ave Unit 284, Fort Rucker, AL 36362-2039 | 2014-06-30 |
| 1548503469 | Lindsey Taylor Mendenhall | Emergency Medical Technician, Basic | Bldg 301 Andrews Ave 1-223rd Hhc, Lyster Army Health Clinic, Fort Rucker, AL 36362 | 2013-03-28 |
| 1194065805 | Brian Joseph Butler | Emergency Medical Technician, Basic | Bulding 301 Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2013-02-18 |
| 1588922108 | Zachary Thomas Fennell | Emergency Medical Technician, Basic | Building 301, Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2012-05-02 |
| 1659657666 | Patrick Anthony Bronson | Emergency Medical Technician, Basic | Bld. 301 Andrews Avn., Fort Rucker, AL 36362-4444 | 2011-10-24 |
| 1346559770 | Melissa Kay Thomas | Emergency Medical Technician, Basic | 200 N Harris Drive, Fort Rucker, AL 36362 | 2010-10-04 |
| 1912130337 | Rishana Amanda Dunn | Emergency Medical Technician, Basic | Building 301 Andrews Ave., Lyster Army Health Clinic, Fort Rucker, AL 36362-5333 | 2009-09-02 |
| 1932347275 | Adam Christopher Heath | Emergency Medical Technician, Basic | 34 Thorne St, Fort Rucker, AL 36362-2102 | 2009-01-24 |
| Find all providers in FORT RUCKER | ||||
| City | FORT RUCKER |
| Zip Code | 36362 |
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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.