JORDAN E WALDRON (NPI# 1093174278) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093174278 |
| Entity Type | Individual |
| Full Name | JORDAN E WALDRON |
| Credential | PA-C |
| Practice Address |
4316 James Casey St Bldg B Ste 201 Austin TX 78745-7874 |
| Mailing Address |
4316 James Casey St Bldg B Ste 201 Austin TX 78745 |
| Practice Telephone | 5124422727 |
| Practice Fax Number | 5124422728 |
| Mailing Telephone | 1244227275 |
| Mailing Fax Number | 1244227285 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2020-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PT2016-014 | AR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AR | MEDICAL LICENSE | PA-661 | 01 |
| TX | MEDICAL LICENSE | PA13068 | 01 |
| AR | 212483795 | 05 | |
| AR | NPI | 1093174278 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10301 Kanis Rd, Little Rock, AR 722056205 | 5016046900 | 5016046941 |
| Street Address |
4316 JAMES CASEY ST BLDG B STE 201 |
| City | AUSTIN |
| State | TX |
| Zip Code | 78745-7874 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194721829 | Jeffrey W Fluitt | Chiropractor | 4316 James Casey St, Bldg B, Suite 201, Austin, TX 78745-1116 | 2005-06-27 |
| 1528625407 | Kyle Gardner | Chiropractor | 4316 James Casey St, Austin, TX 78745-1116 | 2019-05-25 |
| 1558823591 | Madison Casper | Physician Assistant | 4316 James Casey St, Austin, TX 78745-1116 | 2019-04-01 |
| 1164909529 | Dipti Ashmita Schraegle | Clinical Nurse Specialist | 4316 James Casey St, Austin, TX 78745-1116 | 2018-07-27 |
| 1003329236 | Jessica Anne Brown | Nurse Practitioner | 4316 James Casey St, Austin, TX 78745-1116 | 2017-11-09 |
| 1184097982 | Imaging Partners of Austin LLC | Clinic/Center | 4316 James Casey St, F-110b, Austin, TX 78745-1116 | 2015-11-03 |
| 1205203346 | Imaging Partners of Austin LLC | Clinic/Center | 4316 James Casey St, Suite F110-b, Austin, TX 78745-1116 | 2015-08-24 |
| 1235514704 | Central Texas Pain Center North, Pllc | Pain Medicine | 4316 James Casey St, Bldg B, Suite 200, Austin, TX 78745-1116 | 2015-07-27 |
| 1346624202 | Liberty Labs LLC | Clinical Medical Laboratory | 4316 James Casey St, Building F, Austin, TX 78745-1116 | 2015-07-10 |
| 1376935031 | Btdi Jv, LLP | Physiological Laboratory | 4316 James Casey St, Suite E-1, Austin, TX 78745-1116 | 2015-03-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023617511 | Samantha Lynne Weston | Speech-Language Pathologist | 8515 Brodie Lane, Apt 2011, Austin, TX 78745 | 2020-10-26 |
| 1275172686 | Nithphaphone Tracy Bounsing | Registered Nurse | 4316 James Casey St, Building F, Suite 201, Austin, TX 78745 | 2020-01-02 |
| 1225685712 | Integrative Medical Group of Texas | General Practice | 6905 West Gate Blvd. Ste A, Austin, TX 78745 | 2019-08-20 |
| 1962971499 | Kimberly Angela Mancini | Social Worker | 5015 South Ih 35 Frontage Road, Austin, TX 78745 | 2018-11-14 |
| 1093223885 | Emma Rose Marek | Speech-Language Pathologist | 2700 Norfolk Drive, Austin, TX 78745 | 2018-01-16 |
| 1528586690 | Ashley Ellison | Social Worker | 4201 South Congress, Austin, TX 78745 | 2017-09-08 |
| 1134666761 | Carey Sebera | Counselor | 2812 Goldbridge Dr, Austin, TX 78745 | 2017-01-20 |
| 1932644507 | Maya Conlon | Social Worker | 2501 W. William Cannon Dr., Bldg 6 Ste. A, Austin, TX 78745 | 2017-01-05 |
| 1285189134 | 512 Physical Therapy and Golf Performance Center | Physical Therapist | 6800 Westgate Blvd, Suite 117, Austin, TX 78745 | 2016-08-22 |
| 1326401803 | Chris Winkley | Physical Therapist | 5510 S Ih 35 Frontage Rd #240, Austin, TX 78745 | 2016-04-01 |
| Find all providers in zip 78745 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174123111 | Stephanie Rae Moench | Physician Assistant | 1704 Enfield Rd Apt 102, Austin, TX 78703-3348 | 2020-10-28 |
| 1376140400 | April L Thepsoumane | Physician Assistant | 4808 Hale Dr, Austin, TX 78749-3711 | 2020-10-01 |
| 1366050353 | Katherine Elizabeth Mankus | Physician Assistant | 12319 N Mopac Expy Ste 250, Austin, TX 78758-2499 | 2020-07-16 |
| 1629695044 | Brittany Ho | Physician Assistant | 12601 Scofield Farms Dr, Austin, TX 78727-4542 | 2020-07-01 |
| 1679197925 | Malia Scott | Physician Assistant | 2217 Park Bend Dr, Austin, TX 78758-5365 | 2020-06-02 |
| 1659992451 | Christopher Kent Brown | Physician Assistant | 2200 W 35th St Bldg 8, Austin, TX 78703-1222 | 2020-05-03 |
| 1982236550 | Stephen Young | Physician Assistant | 10001 S Ih 35 Ste 320, Austin, TX 78747-1705 | 2020-02-11 |
| 1528608908 | Megan Paige Sutphin | Physician Assistant | 1333 Shore District Dr Apt 1655, Austin, TX 78741-1317 | 2020-01-13 |
| 1235771403 | Central Ortho Assists Pllc | Physician Assistant | 501 Congress, Suite 150, Austin, TX 78701 | 2019-10-09 |
| 1619528569 | Lauren Michelle Feierstein | Physician Assistant | 4505 Duval St Apt 115, Austin, TX 78751-3225 | 2019-09-23 |
| Find all providers in AUSTIN | ||||
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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.