ANDREA JORDAN (NPI# 1871061879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871061879 |
| Entity Type | Individual |
| Full Name | ANDREA JORDAN |
| Credential | QBHP |
| Practice Address |
300 N Clifton St Fordyce AR 71742-3055 |
| Practice Telephone | 8703525122 |
| Practice Fax Number | 8703525127 |
| Mailing Telephone | 8703525122 |
| Mailing Fax Number | 8703525127 |
| Enumeration Date | 2018-11-07 |
| Last Update Date | 2018-11-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790169035 | Andrea Jordan | Licensed Practical Nurse | 9008 Burt Rd, Detroit, MI 48228-1610 | 2015-07-16 |
| 1811266638 | Andrea Paola Jordan | Counselor | 1485 Stonebrook St, Azusa, CA 91702-1423 | 2011-12-22 |
| 1164035010 | Andrea Jordan | Nurse Practitioner | 1202 Martin Luther King Jr Way, Tacoma, WA 98405-3926 | 2020-08-28 |
| 1255818407 | Andrea L Jordan | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-07-20 |
| 1972922888 | Andrea Jordan | Registered Nurse | 910 W 5th Ave, Suite 102, Spokane, WA 99204-2966 | 2014-04-08 |
| 1912331265 | Andrea L Jordan | Dental Hygienist | 895 7th St E, Saint Paul, MN 55106 | 2013-08-22 |
| 1144661075 | Andrea Elizabeth Jordan | Dentist | 1691 El Camino Real, Suite 200, Palo Alto, CA 94306-1053 | 2013-07-08 |
| 1023357126 | Andrea Jordan | Counselor | 1101 Broadway St Ste 230, Vancouver, WA 98660-3320 | 2013-02-08 |
| 1245562321 | Andrea Jordan | Pharmacist | 3000 Ericsson Dr, Ste 100, Warrendale, PA 15086-6501 | 2010-02-01 |
| 1902056047 | Andrea Jordan | Counselor | 303 W Water St, Flint, MI 48503-5627 | 2008-09-25 |
| Street Address |
300 N CLIFTON ST |
| City | FORDYCE |
| State | AR |
| Zip Code | 71742-3055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619007226 | Tracy Pefferkorn | Counselor | 300 N Clifton St, Fordyce, AR 71742-3055 | 2007-03-06 |
| 1548872450 | Brittany Freeman | Case Manager/Care Coordinator | 300 N Clifton St, Fordyce, AR 71742-3055 | 2020-08-21 |
| 1679111975 | Sheena Garrard | Counselor | 300 N Clifton St, Fordyce, AR 71742-3055 | 2019-12-17 |
| 1972071975 | Leslie Brandon | Counselor | 300 N Clifton St, Fordyce, AR 71742-3055 | 2018-11-07 |
| 1174041107 | Karol Thompson | Case Manager/Care Coordinator | 300 N Clifton St, Fordyce, AR 71742-3055 | 2017-08-30 |
| 1427440254 | Jeanna Pennington | Counselor | 300 N Clifton St, Fordyce, AR 71742-3055 | 2015-03-03 |
| 1073937207 | Brandy Tydingco | Counselor | 300 N Clifton St, Fordyce, AR 71742-3055 | 2014-02-07 |
| 1790057263 | Megan Elizabeth Launius | Social Worker | 300 N Clifton St, Fordyce, AR 71742-3055 | 2012-01-31 |
| 1902178619 | Bhc Pinnacle Pointe Hospital, Inc. | Clinic/Center | 300 N Clifton St, Fordyce, AR 71742 | 2012-01-27 |
| 1376842344 | Stephanie Newton | Counselor | 300 N Clifton St, Fordyce, AR 71742-3055 | 2011-03-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699946723 | Harry R. Denison, P.a. | Durable Medical Equipment & Medical Supplies | 312 Spring St., Fordyce, AR 71742 | 2008-03-17 |
| 1154541878 | St.john's Place of Arkansas, LLC | Skilled Nursing Facility | 815 Baxter St, Fordyce, AR 71742 | 2007-04-26 |
| 1952482036 | Habilitation Center, LLC | Intermediate Care Facility, Mentally Retarded | 1828 Industrial Dr, Fordyce, AR 71742 | 2006-10-17 |
| 1669423810 | Warmack Pharmacies Inc | Pharmacy | 802 W 4th St, Fordyce, AR 71742 | 2006-05-12 |
| 1306826029 | Board of Governors of Dallas County Medical Center | General Acute Care Hospital | 201 North Clifton Street, Fordyce, AR 71742 | 2006-01-19 |
| 1063013365 | Derek White | Pharmacist | Walmart Pharmacy, 1123 Highway 79-167 Bypass, Fordyce, AR 71742 | 2020-11-03 |
| 1962983395 | Warmack Pharmacies Inc | Pharmacy | 802 W 4th St, Fordyce, AR 71742 | 2018-08-23 |
| 1346378528 | Board of Governors of Dallas County Medical Center | Clinic/Center | 201 North Clifton Street, Fordyce, AR 71742 | 2007-03-01 |
| 1043308935 | Board of Governors of Dallas County Medical Center | Emergency Medicine | 201 North Clifton Street, Fordyce, AR 71742 | 2006-10-10 |
| 1326113689 | St. John's Place of Arkansas | Nursing Facility/Intermediate Care Facility | 815 Baxter St., Fordyce, AR 71742-1025 | 2006-11-22 |
| Find all providers in zip 71742 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235447319 | Don R Smith Jr. | Case Manager/Care Coordinator | 935 Ford Dr, Fordyce, AR 71742-7034 | 2010-09-22 |
| 1548872450 | Brittany Freeman | Case Manager/Care Coordinator | 300 N Clifton St, Fordyce, AR 71742-3055 | 2020-08-21 |
| 1174041107 | Karol Thompson | Case Manager/Care Coordinator | 300 N Clifton St, Fordyce, AR 71742-3055 | 2017-08-30 |
| 1003156795 | Shanna Marlar | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2013-02-18 |
| 1588984017 | Kimra Lynn Osburn | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2010-06-07 |
| 1407188055 | Cynthia Cayton | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2010-02-08 |
| 1124359633 | Samara Nolen | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2010-01-22 |
| 1093046997 | Robin Johnston Radford | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2010-01-18 |
| 1861720112 | Deirdra Sandoral Kervin | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2009-11-25 |
| 1679706857 | Youlonda Nix Miller | Case Manager/Care Coordinator | 1101 W 3rd St, Fordyce, AR 71742-3014 | 2009-09-03 |
| Find all providers in FORDYCE | ||||
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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.