ANTHONY L. JORDAN HEALTH CORPORATION (NPI# 1649529678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649529678 |
| Entity Type | Organization |
| Organization Name | ANTHONY L. JORDAN HEALTH CORPORATION |
| Other Organization Name | JORDAN AT CCIA |
| Practice Address |
120 N Main St Suite 11 Canandaigua NY 14424-1258 |
| Mailing Address |
82 Holland Street Rochester NY 14605-2131 |
| Practice Telephone | 5853966980 |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-07 |
| Authorized Official Name | BRIDGETTE WIEFLING (PRESIDENT/CEO) |
| Authorized Official Telephone | 5854232878 |
| Authorized Official Credential | MD |
| 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 |
| Other Name | Type Code |
|---|---|
| Jordan at CCIA | 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 |
| 1568711596 | Anthony L. Jordan Health Corporation | Clinic/Center | 151 Parsells Ave, Jordan Health At Community Place, Rochester, NY 14609 | 2012-09-06 |
| 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 |
| Street Address |
120 N MAIN ST SUITE 11 |
| City | CANANDAIGUA |
| State | NY |
| Zip Code | 14424-1258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700429461 | Kimberlie Noyes | Registered Nurse | 120 N Main St, Canandaigua, NY 14424-1258 | 2019-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730725029 | Stefanie Ann Hook | Nurse Practitioner | 395 West Street, Suite 101, Canandaigua, NY 14424 | 2019-11-21 |
| 1285120618 | Mary Kathleen Woodruff | Counselor | 163 Gibson Street, Canandaigua, NY 14424 | 2018-07-09 |
| 1699260612 | Victoria Record | Nurse Practitioner | 3325 Marvin Sands Dr, Canandaigua, NY 14424 | 2018-06-22 |
| 1649767443 | Liana Irene Schenk | Counselor | 5297 Parkside Drive, Building 400, Suite 408, Canandaigua, NY 14424 | 2018-04-17 |
| 1225534019 | Brook Slaby | Counselor | 5297 Parkside Dr Building 400 Office 411, Canandaigua, NY 14424 | 2018-04-02 |
| 1154839710 | Madasyn Leigh Smith | Physical Therapist | 229 Parrish St Ste 220, Canandaigua, NY 14424 | 2018-01-17 |
| 1295259992 | Melissa Ann Frarey | Licensed Practical Nurse | 4998 Wyffels Road, Canandaigua, NY 14424 | 2017-08-03 |
| 1235674599 | Wendy Williams | Early Intervention Provider Agency | 5145 North Bloomfiled Road, Canandaigua, NY 14424 | 2016-12-22 |
| 1326418252 | Mary Christine Casella | Registered Nurse | 90 West Gibson Street, Canandaigua, NY 14424 | 2015-10-05 |
| 1417351453 | Holly Jean Jackson | Licensed Practical Nurse | 5a Lafayette Avenue, Canandaigua, NY 14424 | 2014-10-20 |
| Find all providers in zip 14424 | ||||
| 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 |
|---|---|---|---|---|
| 1265046940 | William F Ryan Community Health Center Inc | Clinic/Center | 154 Wadsworth Avenue, New York, NY 10033 | 2020-09-01 |
| 1518581297 | Cornerstone Family Healthcare | Clinic/Center | 290 Broadway Ste 2&3, Newburgh, NY 12550-5441 | 2020-05-29 |
| 1871128371 | Regional Health Reach Inc. | Clinic/Center | 89 Genesee St Ste 1408, Rochester, NY 14611-3201 | 2020-03-05 |
| 1184263485 | Urban Health Plan, Inc. | Clinic/Center | 271 E 138th St, Bronx, NY 10454-2909 | 2020-01-03 |
| 1962040246 | Community Health Project Inc. | Clinic/Center | 40 Flatbush Avenue Extension, Brooklyn, NY 11201 | 2019-12-17 |
| 1245886753 | Care for The Homeless | Clinic/Center | 91 Junius St, Brooklyn, NY 11212-8021 | 2019-08-12 |
| 1184186496 | Oda Primary Health Care Network, Inc. | Clinic/Center | 74 Wallabout Street, Brooklyn, NY 11249 | 2019-04-04 |
| 1538621289 | Ezras Choilim Health Center, Inc. | Clinic/Center | 49 Forest Rd Fl 3, Monroe, NY 10950-2923 | 2019-04-02 |
| 1134693708 | Rochester Primary Care Network, Inc | Clinic/Center | 3 Parkside Ct Bldg 1, Utica, NY 13501-5643 | 2019-01-17 |
| 1164994190 | Morris Heights Health Center, Inc. | Clinic/Center | 1 W Burnside Ave, Bronx, NY 10453-4003 | 2019-01-02 |
| Find all providers with the same taxonomy | ||||
| City | CANANDAIGUA |
| Zip Code | 14424 |
Please comment or provide details below to improve the information on ANTHONY L. JORDAN HEALTH CORPORATION.
| 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.