RANDALL G. JORDAN (NPI# 1801887799) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801887799 |
| Entity Type | Individual |
| Full Name | RANDALL G. JORDAN |
| Credential | PSYD |
| Practice Address |
1841 Honeysuckle Rd Dothan AL 36305-4269 |
| Practice Telephone | 3347942113 |
| Practice Fax Number | 3347021220 |
| Mailing Telephone | 3347942113 |
| Mailing Fax Number | 3347021220 |
| Enumeration Date | 2005-10-31 |
| Last Update Date | 2009-03-12 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
634 | AL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AL | 104596 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003917956 | Randall W Jordan | Optometrist | 1107 E South Greer Street, Cordele, GA 31015 | 2006-09-25 |
| Street Address |
1841 HONEYSUCKLE RD |
| City | DOTHAN |
| State | AL |
| Zip Code | 36305-4269 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528393659 | Lloyd E. Howell | Counselor | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2009-10-07 |
| 1073754503 | Kimberly M. Jaggars | Counselor | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2009-03-12 |
| 1750522447 | Kimberly M Jaggars | Counselor | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2009-03-10 |
| 1275783482 | Therapeutic Resources Inc | Psychiatric Residential Treatment Facility | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2008-09-24 |
| 1992960603 | Larry E Beauchamp Jr. | Marriage & Family Therapist | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2008-07-22 |
| 1346434164 | Robert S, Kline IIi, Psy.d. | Psychologist | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2007-09-05 |
| 1841340809 | Maryla Izabella Madura | Psychologist | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2007-01-11 |
| 1396756227 | Robert Samuel Kline | Psychologist | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2006-08-09 |
| 1972512788 | Chuck Emmett | Counselor | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2006-08-08 |
| 1891704920 | Jeffery Charles Justice | Counselor | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2006-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962059998 | Samantha Nicole Bolden | Counselor | 1001 John D. Odom Road, Dothan, AL 36305 | 2019-08-23 |
| 1578968780 | Aba Therapy & Consulting Services | Behavioral Analyst | 3124 West Main Street, Suite 9, Dothan, AL 36305 | 2014-10-30 |
| 1306247796 | Tracey Lynn Carter | Registered Nurse | 4300 W Main St Ste 102, Dothan, AL 36305 | 2014-09-04 |
| 1760829881 | Michael Brent Nance | Nurse Practitioner | 4370 West Main Street, Dothan, AL 36305 | 2013-05-30 |
| 1033495221 | Professional Resource Management of Wiregrass, LLC | Psychiatry & Neurology | 2812 Hartford Hwy Ste 1, Dothan, AL 36305 | 2011-11-01 |
| 1649555483 | Ashley Dawn Morrow | Pharmacist | 2940 West Main Street, Dothan, AL 36305 | 2011-10-12 |
| 1740599273 | Aline M Mays-easley | Counselor | 309 Ameris Ave, Dothan, AL 36305 | 2010-10-01 |
| 1356671408 | Kimberly Jones Rogers | Clinical Neuropsychologist | 200 Grove Park Ln Ste 212, Dothan, AL 36305 | 2010-01-12 |
| 1639347818 | Southeast Alabama Counseling & Behavioral Specialist | Residential Treatment Facility, Emotionally Disturbed Children | 407 Honeysuckle Rd Ste 207, Dothan, AL 36305 | 2008-02-11 |
| 1770705667 | Michala Long | Pharmacist | 3850 West Main St, Dothan, AL 36305 | 2007-05-02 |
| Find all providers in zip 36305 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134525207 | Cogito Mental Health Services, LLC | Psychologist | 248 N Foster St, Dothan, AL 36303-4542 | 2014-11-17 |
| 1740683473 | David Payne | Psychologist | 104 Huckleberry Ln, Dothan, AL 36303-1306 | 2014-10-08 |
| 1265489538 | David Carl Ghostley | Psychologist | 202 N Bell St, Dothan, AL 36303-4310 | 2006-05-30 |
| 1578921888 | Jenny Quevedo | Psychologist | 408 Healthwest Dr, Dothan, AL 36303-2054 | 2016-02-01 |
| 1841340809 | Maryla Izabella Madura | Psychologist | 1841 Honeysuckle Rd, Dothan, AL 36305-4269 | 2007-01-11 |
| 1215032990 | Melanie K Cotter | Psychologist | 100 Westside Drive, Dothan, AL 36303 | 2006-09-14 |
| 1225079114 | David C Ghostley Psyd Inc | Psychologist | 202 N Bell St, Dothan, AL 36303-4310 | 2006-06-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063050300 | Abby Pullen Clark | Psychologist | 801 Noble St Ste 400, Anniston, AL 36201-5698 | 2019-12-17 |
| 1720624380 | Cynthia Ann Neville | Psychologist | 203 17th St N, Bessemer, AL 35020-5726 | 2019-11-19 |
| 1457992588 | Teashia Adkins Goodwin | Psychologist | 500 Southland Dr Ste 155-f, Vestavia, AL 35226-3711 | 2019-09-30 |
| 1750941365 | Kristen Marie Smith | Psychologist | 3125 Independence Dr Ste 114, Birmingham, AL 35209-4163 | 2019-06-17 |
| 1952864225 | Parris Psychology | Psychologist | 1971 Appalachian Hwy, Hokes Bluff, AL 35903-4747 | 2019-04-12 |
| 1245791789 | Lori Lea Holth | Psychologist | 5820 Morris Ave, Gadsden, AL 35903-4831 | 2019-03-27 |
| 1023581246 | Elizabeth Fair | Psychologist | 3168 Midtown Park S Ste E, Mobile, AL 36606 | 2019-01-10 |
| 1487139119 | Natalie Harrison | Psychologist | 400 Vestavia Pkwy Ste 101, Vestavia, AL 35216-3750 | 2018-09-28 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1508391467 | Eric Todd Bloch | Psychologist | 2061 County Road 430, Smiths Station, AL 36877 | 2017-04-27 |
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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.