JORDAN PHYSICIAN ASSOCIATES, INC (NPI# 1083056873) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083056873 |
| Entity Type | Organization |
| Organization Name | JORDAN PHYSICIAN ASSOCIATES, INC |
| Other Organization Name | JORDAN OB/GYN |
| Practice Address |
46 Obery Street Plymouth MA 02360 |
| Mailing Address |
36 Cordage Park Cir Suite 317 Plymouth MA 02360-7331 |
| Practice Telephone | 5088302082 |
| Practice Fax Number | 5088302502 |
| Mailing Telephone | 5088302082 |
| Mailing Fax Number | 5088302502 |
| Enumeration Date | 2013-07-23 |
| Last Update Date | 2013-07-23 |
| Authorized Official Name | DR. JAMES FANALE (SR VP OF SYSTEM DEVELOPMENT) |
| Authorized Official Telephone | 5087462000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | JORDAN PHYSICIAN ASSOCIATES, INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110072193A | 05 |
| Other Name | Type Code |
|---|---|
| Jordan OB/GYN | Doing Business As Name - Organization |
| Street Address |
46 OBERY STREET |
| City | PLYMOUTH |
| State | MA |
| Zip Code | 02360 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801425053 | Geraldine Veronica Thissell | Speech-Language Pathologist | 28 Nathan Lane, Plymouth, MA 02360 | 2020-04-08 |
| 1447889621 | Corrections - Comprehensive Treatment Centers, LLC | Clinic/Center | One Bumps Pond Road, Plymouth, MA 02360 | 2020-04-08 |
| 1427690247 | Osp Children's Therapy Center | Physical Therapist | 130 Industrial Park Rd. A, Plymouth, MA 02360 | 2019-10-14 |
| 1265996219 | Housecall Physicians, Inc | Family Medicine | 31 Home Depot Drive, Suite 283, Plymouth, MA 02360 | 2019-01-24 |
| 1306329271 | Patricia Jane Whitaker | Social Worker | Masac-plymouth, 1 Bumps Pond Road, Plymouth, MA 02360 | 2018-09-07 |
| 1366934572 | Cindy Oneil | Registered Nurse | 10 Cordage Park, Plymouth, MA 02360 | 2018-06-04 |
| 1275021685 | Alexandra Andrew | Acupuncturist | 225 Water St Ste B239, Plymouth, MA 02360 | 2018-05-01 |
| 1417445289 | Susan Ann Adams | Case Manager/Care Coordinator | 260 Ship Pond Rd, Plymouth, MA 02360 | 2018-04-27 |
| 1588178776 | Cassandra Noel Denayer | Registered Nurse | 7 Rodman Lane, Plymouth, MA 02360 | 2017-11-27 |
| 1205345576 | Chibueze George Okoro | Dentist | Dr Dental 125 Samoset Street, Plymouth, MA 02360 | 2017-09-29 |
| Find all providers in zip 02360 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205046646 | Merida A Miller | Obstetrics & Gynecology | 4155 Cty Rd 101 N, Plymouth, MN 55446 | 2007-05-23 |
| 1376686832 | Sanford E Leslie | Obstetrics & Gynecology | 147 Court St, Plymouth, MA 02360-3807 | 2007-02-15 |
| 1114083045 | Joel J Baron | Obstetrics & Gynecology | 2 Driftwood Ln, Plymouth, MA 02360-2094 | 2006-12-28 |
| 1275693772 | Deborah S Wooten-angelo | Obstetrics & Gynecology | 101 Court St, 4th Floor Unit 8, Plymouth, MA 02360-8718 | 2006-12-12 |
| 1598785073 | Bora Ozguler | Obstetrics & Gynecology | 16510 Pretty Lake Rd, Suite 106, Plymouth, IN 46563-8264 | 2006-07-20 |
| 1508817891 | Juliann Corsini | Obstetrics & Gynecology | 110 Long Pond Road, Suite 101, Plymouth, MA 02360 | 2006-05-12 |
| 1962477224 | Maryanne C Bombaugh | Obstetrics & Gynecology | 118 Long Pond Rd, Plymouth, MA 02360-2662 | 2006-02-21 |
| 1982688008 | John Ray Addy | Obstetrics & Gynecology | 13200 Cambridge Ct, Plymouth, MI 48170-3099 | 2005-12-01 |
| 1356324057 | Plymouth Ob-gyn Associates Inc | Obstetrics & Gynecology | 101 Long Pond Road, Suite 101, Plymouth, MA 02360 | 2005-11-28 |
| 1932196409 | Noreen C Faulkner | Obstetrics & Gynecology | 1919 Lake Ave Ste 106, Plymouth, IN 46563-7830 | 2005-09-30 |
| Find all providers in PLYMOUTH | ||||
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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.