MR. JORDAN A BLEECKER (NPI# 1154898062) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154898062 |
| Entity Type | Individual |
| Full Name | MR. JORDAN A BLEECKER |
| Credential | PA-S |
| Practice Address |
2300 Maccorkle Ave Se Charleston WV 25304-1045 |
| Mailing Address |
1021 Wilkie Dr # 2 Charleston WV 25314-1722 |
| Practice Telephone | 2043574710 |
| Mailing Telephone | 8054507619 |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2300 Maccorkle Ave Se, Charleston, WV 253041045 | 2043574710 |
| Street Address |
2300 MACCORKLE AVE SE |
| City | CHARLESTON |
| State | WV |
| Zip Code | 25304-1045 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659363950 | Laura P Welch | Pharmacist | 2300 Maccorkle Ave Se, University of Charleston School of Pharmacy, Charleston, WV 25304-1045 | 2005-08-22 |
| 1235787664 | Rebekah Coleen Warrington | Specialist/Technologist | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2019-08-28 |
| 1396203519 | Chloe Nellie Massaro | Specialist/Technologist | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2019-03-06 |
| 1649737818 | Alfonso Jose Davila Davila | Specialist/Technologist | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2019-02-25 |
| 1720552946 | Jacob David Winkle | Specialist/Technologist | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2019-01-22 |
| 1689148884 | Siarra Harringtn | Student in an Organized Health Care Education/Training Program | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2019-01-22 |
| 1497219646 | Allie Robinson | Student in an Organized Health Care Education/Training Program | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2019-01-22 |
| 1083150437 | Kenji Ueda | Specialist/Technologist | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2017-01-10 |
| 1922541564 | Jennifer M Barley | Pharmacist | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2016-11-30 |
| 1124475652 | Alex Stratton | Student in an Organized Health Care Education/Training Program | 2300 Maccorkle Ave Se, Charleston, WV 25304-1045 | 2016-05-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740893908 | Sade Yvonne Rice | Technician | 392 B South Parkd Rd, Charleston, WV 25304 | 2020-08-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1447811872 | Kwasi Amponsah Gambrah | Student in an Organized Health Care Education/Training Program | 3200 Mac Corkle Ave. Se, Robert C. Byrd Clinical Teaching Center, 5th Floor, Charlestoni, WV 25304 | 2019-06-26 |
| 1457916751 | Divya Kalluru | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast, Robert C. Bird Clinica, 4th Floor Internal Medicine Department, Charleston, WV 25304 | 2019-05-02 |
| 1841854965 | Sean Michael Percy Losier | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave., Se, Camc Family Medicine Center Robert C. Byrd Clinical Tea, Charleston, WV 25304 | 2019-04-24 |
| 1700440047 | Priyanka Chowdhry | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 4th Floor, 3200 Maccorkle Avenue, Southeast, Charleston, WV 25304 | 2019-04-23 |
| 1568925469 | Saranya Dinesan | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Ave. Se, 4th Floor, Robert C. Byrd Clini, Charleston, WV 25304 | 2019-04-09 |
| 1043771694 | Mary Elizabeth Novak | Student in an Organized Health Care Education/Training Program | Camc Memorial Hospital, Surgicare Center, 3200 Maccorkle Ave Se, Charleston, WV 25304 | 2019-03-27 |
| 1124518600 | Abdullah Sohail | Student in an Organized Health Care Education/Training Program | 4th Floor, 3200 Maccorkle Ave, South East Robert C. Bir, Charleston, WV 25304 | 2018-05-10 |
| Find all providers in zip 25304 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144833823 | Shadi Adib Bashai | Student in an Organized Health Care Education/Training Program | 743 1/2 Washington St W, Charleston, WV 25302-1844 | 2020-08-24 |
| 1043837883 | Jacey Renee Dillon | Student in an Organized Health Care Education/Training Program | 2119 Stoner Dr W, Charleston, IL 61920-3723 | 2020-06-27 |
| 1053931410 | Pir Ali Shah | Student in an Organized Health Care Education/Training Program | 3200 Maccorkle Avenue Southeast Robert C. Bind Clinical, Charleston, WV 25304 | 2020-04-25 |
| 1629698865 | Umer Muhammad | Student in an Organized Health Care Education/Training Program | Childrens Medicine Center, 800 Pennsylvania Ave, Charleston, WV 25302 | 2020-04-17 |
| 1730718891 | Ryan Metts | Student in an Organized Health Care Education/Training Program | 211 Ashley Ave Apt B, Charleston, SC 29403-6859 | 2020-04-02 |
| 1598393506 | Khadija Naseem | Student in an Organized Health Care Education/Training Program | Robert C. Bird Clinical Training Center, 3200 Maccorkle Avenue Southeast, Charleston, WV 25304-1208 | 2020-03-27 |
| 1235766411 | Abhishek Yadav | Student in an Organized Health Care Education/Training Program | 101 29th St Se Apt 20, Charleston, WV 25304-1149 | 2020-03-26 |
| 1649807603 | Jasmine Shah | Student in an Organized Health Care Education/Training Program | 3110 Maccorkle Avenue, Se, Student Services Department - Wvu Building, 4th Floor, Charleston, WV 25304 | 2020-03-26 |
| 1861027815 | Robert Bryce Robbins | Student in an Organized Health Care Education/Training Program | Search Results 171 Ashley Ave, Charleston, SC 29425-0001 | 2020-03-10 |
| 1700426343 | Mikaela Kiser | Student in an Organized Health Care Education/Training Program | 3813 Staunton Ave Se Unit A, Charleston, WV 25304-1537 | 2020-01-12 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 25304 |
Please comment or provide details below to improve the information on MR. JORDAN A BLEECKER.
| 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.