ALTA JORDAN (NPI# 1457702144) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457702144 |
| Entity Type | Individual |
| Full Name | ALTA JORDAN |
| Credential | AGACNP |
| Practice Address |
108 Palmetto Park Blvd Suite C Lexington SC 29072-7968 |
| Practice Telephone | 8033560949 |
| Practice Fax Number | 8033561795 |
| Mailing Telephone | 8033560949 |
| Mailing Fax Number | 8033561795 |
| Enumeration Date | 2016-06-24 |
| Last Update Date | 2016-06-24 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
20190 | SC | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
108 PALMETTO PARK BLVD SUITE C |
| City | LEXINGTON |
| State | SC |
| Zip Code | 29072-7968 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851343065 | Carolina Cardiovascular Associates Pa | Internal Medicine | 108 Palmetto Park Blvd, Ste D, Lexington, SC 29072-7968 | 2006-05-16 |
| 1093326985 | Lauren Taylor Lollar | Counselor | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2020-08-13 |
| 1215416870 | Katie Brave | Counselor | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2018-08-13 |
| 1891292330 | Stephanie Helbeck Cornfield | Social Worker | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2018-04-11 |
| 1790284636 | Yiasha L Edwards | Counselor | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2018-02-06 |
| 1952823916 | Vincent Albano | Specialist/Technologist | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2017-07-12 |
| 1043730757 | Kendra Speckman | Counselor | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2017-06-23 |
| 1609302355 | Justin Suddeth | Counselor | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2017-05-02 |
| 1245685437 | Jerry Cue | Behavioral Analyst | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2016-04-26 |
| 1649605247 | Providence Cardiology | Internal Medicine | 108 Palmetto Park Blvd, Lexington, SC 29072-7968 | 2013-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700484821 | Grace Physicians Services | Clinic/Center | 1483 Old Cherokee Road, Lexington, SC 29072 | 2020-10-12 |
| 1750995007 | Trinity Health and Wellness | Clinic/Center | 1483 Old Cherokee Rd, Lexington, SC 29072 | 2020-09-03 |
| 1730727629 | Erika Watts | Occupational Therapist | 100 Tarrar Springs Road, Sped, Lexington, SC 29072 | 2019-12-11 |
| 1194380600 | Lexington County Health Services District, Inc. | Clinic/Center | 154 Saluda Pointe Ct, Lexington, SC 29072 | 2019-05-09 |
| 1962973768 | William R. Key | Counselor | Lexington Community Mental Health Center, 301 Palmetto Park Boulevard, Lexington, SC 29072 | 2018-12-06 |
| 1639651961 | Lindsey Terry | Social Worker | 108 Palmetto Pk. Boulveard, Suite D, Lexington, SC 29072 | 2018-09-04 |
| 1922594126 | Dental Professional of South Carolina, P.C. | Dentist | 2448 Augusta Hwy, Lexington, SC 29072 | 2018-07-11 |
| 1598251605 | Lynn Marceline Beckett-lowe | Nurse Practitioner | 124 Pink Camellia Lane, Lexington, SC 29072 | 2018-07-02 |
| 1083120620 | Diana Reiss | Counselor | 714 S Lake Drive, 120, Lexington, SC 29072 | 2017-12-19 |
| 1649781857 | Constance Jean Lynch | Occupational Therapist | 800 North Lake Boulevard, Lexington, SC 29072 | 2017-10-14 |
| Find all providers in zip 29072 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548868367 | Emily Han | Nurse Practitioner | 3245 Orchard Grass Rd, Lexington, KY 40509-8639 | 2020-10-14 |
| 1548740111 | Doreen M Legere | Nurse Practitioner | Uk Division of Pulmonary Critical Care 800 Rose St, Lexington, KY 40536-0001 | 2018-08-14 |
| 1548747884 | William Brian James | Nurse Practitioner | Univ of Ky 800 Rose Street, Lexington, KY 40536-0001 | 2018-07-19 |
| 1851608459 | Shannon C Shumaker | Nurse Practitioner | 800 Rose Street Gill Heart Institute, Lexington, KY 40536-0298 | 2010-09-03 |
| 1578890224 | Dana Lenore Smith | Nurse Practitioner | 4711 Sunset Boulevard, Agape Primary Care At Twelve Mile Creek, Lexington, SC 29072 | 2009-11-17 |
| 1598090243 | Jill Marie Clemmons | Nurse Practitioner | University of Kentucky Department Of, 740 South Limestone St. Room A125, Lexington, KY 40536-0001 | 2009-10-14 |
| 1679712087 | Juliann Paige Matheny | Nurse Practitioner | 138 Leader Ave Suite 119, Lexington, KY 40506-3446 | 2009-02-09 |
| 1508967571 | Carol Lynn Thompson | Nurse Practitioner | Uk Division of Pulmonary Critical Care, 800 Rose Street, Lexington, KY 40536-0284 | 2006-09-25 |
| 1508868266 | Tonja A Gantt | Nurse Practitioner | 716 Old Cherokee Rd, Lexington, SC 29072-9406 | 2005-08-12 |
| 1083616064 | Debra Dellay | Nurse Practitioner | 989 Governors Ln, Ste 180, Lexington, KY 40513-1175 | 2005-08-10 |
| Find all providers in LEXINGTON | ||||
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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.