ANTHONY L. JORDAN HEALTH CORPORATION (NPI# 1568711596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568711596 |
| Entity Type | Organization |
| Organization Name | ANTHONY L. JORDAN HEALTH CORPORATION |
| Other Organization Name | JORDAN HEALTH AT COMMUNITY PLACE |
| Practice Address |
151 Parsells Ave Jordan Health At Community Place Rochester NY 14609 |
| Mailing Address |
82 Holland St Aljhc Rochester NY 14605-2131 |
| Practice Telephone | 5854547530 |
| Mailing Telephone | 5854235800 |
| Mailing Fax Number | 5854232890 |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2015-10-08 |
| Authorized Official Name | JANICE HARBIN (PRESIDENT/CEO) |
| Authorized Official Telephone | 5854235800 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | Y |
| Parent Organization Name | ANTHONY L. JORDAN HEALTH CORPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | MEDICARE PART B PTAN | 16467A | 01 |
| NY | 04065629 | 05 | |
| NY | MEDICARE PART A PTAN | 331838 | 01 |
| Other Name | Type Code |
|---|---|
| Jordan Health at Community Place | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174095640 | Anthony L. Jordan Health Corporation | Clinic/Center | 214 Lake Ave, Rochester, NY 14608-1208 | 2018-12-21 |
| 1457626129 | Anthony L. Jordan Health Corporation | Clinic/Center | 125 Saint Paul St, Rochester, NY 14609 | 2012-03-14 |
| 1437424231 | Anthony L. Jordan Health Corporation | Clinic/Center | 41 Kestrel St, Rochester, NY 14613-2120 | 2012-03-13 |
| 1609141316 | Anthony L. Jordan Health Corporation | Clinic/Center | 666 Plymouth Ave S, Rochester, NY 14608-2766 | 2012-03-13 |
| 1346541414 | Anthony L. Jordan Health Corporation | Clinic/Center | 273 Upper Falls Blvd, Rochester, NY 14605-2103 | 2010-11-05 |
| 1639621709 | Anthony L. Jordan Health Corporation | Clinic/Center | 82 Holland St, Rochester, NY 14605-2131 | 2016-10-25 |
| 1750700399 | Anthony L. Jordan Health Corporation | Clinic/Center | 950 Norton St, Rochester, NY 14621-3732 | 2014-04-10 |
| 1831441534 | Anthony L. Jordan Health Corporation | Clinic/Center | 82 Holland St, Rochester, NY 14605-2131 | 2012-10-05 |
| 1528317567 | Anthony L. Jordan Health Corporation | Clinic/Center | 82 Holland Street, Rochester, NY 14605-2131 | 2012-09-06 |
| 1649529678 | Anthony L. Jordan Health Corporation | Clinic/Center | 120 N Main St, Suite 11, Canandaigua, NY 14424-1258 | 2012-09-06 |
| Street Address |
151 PARSELLS AVE JORDAN HEALTH AT COMMUNITY PLACE |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14609 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154928828 | Aundrea Camille Williams | Licensed Practical Nurse | 99 Meaodw Circle, Rochester, NY 14609 | 2020-10-06 |
| 1043836869 | Sharon Ann Reilly | Registered Nurse | 910 North Goodman Street, Suite 1, Rochester, NY 14609 | 2020-06-17 |
| 1235655671 | Tameka Shaunte Parker | Licensed Practical Nurse | 35 Village Way, Rochester, NY 14609 | 2017-08-17 |
| 1851817472 | Mary Ann Dukes | Registered Nurse | 75 Yates Street, Rochester, NY 14609 | 2017-08-15 |
| 1023533064 | Fernando Caumont | Urology | 2615 Culver Rd Ste 100, Rochester, NY 14609 | 2017-08-10 |
| 1083061162 | Teyanee Latavia Harewood | Registered Nurse | 418 Hayward Ave, Rochester, NY 14609 | 2016-05-19 |
| 1164853891 | Sukhminder Kaur Sahansra | Internal Medicine | 335 North Park Drive, Elderone, Rochester, NY 14609 | 2013-12-05 |
| 1952749863 | Nada Jadrovska | Registered Nurse | 79 Eagle Rock Dr, Rochester, NY 14609 | 2013-06-13 |
| 1457602930 | Lynnetta Maria Hollomon | Licensed Practical Nurse | 827 Edgecreek Trail, Rochester, NY 14609 | 2012-09-25 |
| 1457626129 | Anthony L. Jordan Health Corporation | Clinic/Center | 125 Saint Paul St, Rochester, NY 14609 | 2012-03-14 |
| Find all providers in zip 14609 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871128371 | Regional Health Reach Inc. | Clinic/Center | 89 Genesee St Ste 1408, Rochester, NY 14611-3201 | 2020-03-05 |
| 1174095640 | Anthony L. Jordan Health Corporation | Clinic/Center | 214 Lake Ave, Rochester, NY 14608-1208 | 2018-12-21 |
| 1457626129 | Anthony L. Jordan Health Corporation | Clinic/Center | 125 Saint Paul St, Rochester, NY 14609 | 2012-03-14 |
| 1437424231 | Anthony L. Jordan Health Corporation | Clinic/Center | 41 Kestrel St, Rochester, NY 14613-2120 | 2012-03-13 |
| 1609141316 | Anthony L. Jordan Health Corporation | Clinic/Center | 666 Plymouth Ave S, Rochester, NY 14608-2766 | 2012-03-13 |
| 1346541414 | Anthony L. Jordan Health Corporation | Clinic/Center | 273 Upper Falls Blvd, Rochester, NY 14605-2103 | 2010-11-05 |
| 1003431925 | Greater Seacoast Community Health | Clinic/Center | 63 S Main St, Rochester, NH 03867-2707 | 2020-06-16 |
| 1407331978 | Greater Seacoast Community Health | Clinic/Center | 25 Old Dover Rd, Rochester, NH 03867-3464 | 2018-10-01 |
| 1639621709 | Anthony L. Jordan Health Corporation | Clinic/Center | 82 Holland St, Rochester, NY 14605-2131 | 2016-10-25 |
| 1235680935 | Community Health Service Inc. | Clinic/Center | 1926 College View Rd E, Rctc, Rochester, MN 55904-8201 | 2016-10-18 |
| Find all providers in ROCHESTER | ||||
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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.