MR. KEVIN WAYNE JORDAN (NPI# 1164995148) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164995148 |
| Entity Type | Individual |
| Full Name | MR. KEVIN WAYNE JORDAN |
| Practice Address |
1902 2nd Ave Seattle WA 98101-1155 |
| Mailing Address |
1902 2nd Ave Ste 208 Seattle WA 98101-1186 |
| Practice Telephone | 2069569570 |
| Practice Fax Number | 2064488495 |
| Mailing Telephone | 2069569570 |
| Mailing Fax Number | 2064488495 |
| Enumeration Date | 2019-01-02 |
| Last Update Date | 2019-01-02 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
WA | Behavioral Health & Social Service Providers | |
| Y | 171M00000X | Case Manager/Care Coordinator | WA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275850067 | Kevin R. Jordan | Dentist | 154 Scott St., Olive Hill, KY 41164 | 2010-05-03 |
| 1407998628 | Kevin S. Jordan | Chiropractor | 8889 Mentor Avenue, Mentor, OH 44060 | 2007-02-13 |
| 1790214419 | Kevin P Jordan | Internal Medicine | 281 1st Ave, New York, NY 10003-2925 | 2017-06-06 |
| 1891133377 | Kevin Mitchell Jordan | Family Medicine | 9040 Jackson, Tacoma, WA 98431-5001 | 2013-06-06 |
| 1952600413 | Kevin Jordan | Psychologist | 450 N 7th St, Root Hall, Terre Haute, IN 47809-1928 | 2011-03-23 |
| 1922205889 | Kevin Theophilus Jordan | Emergency Medicine | 1401 Foucher St, New Orleans, LA 70115-3515 | 2007-07-02 |
| 1568528057 | Kevin Jordan | Emergency Medicine | 5100 W Broad St, Columbus, OH 43228-1607 | 2006-12-29 |
| Street Address |
1902 2ND AVE |
| City | SEATTLE |
| State | WA |
| Zip Code | 98101-1155 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104007228 | Jungwon Yoon | Counselor | 1902 2nd Ave, Seattle, WA 98101 | 2007-11-16 |
| 1114525292 | Natalie Kendall Robinson | Counselor | 1902 2nd Ave, Seattle, WA 98101-1155 | 2020-10-12 |
| 1780290825 | Peter Mcbride | Social Worker | 1902 2nd Ave, Suite 208, Seattle, WA 98101-1155 | 2020-09-22 |
| 1104431501 | Ma Rita P Manalastas | Student in an Organized Health Care Education/Training Program | 1902 2nd Ave, Seattle, WA 98101-1155 | 2020-09-11 |
| 1912515180 | Nicole Lynn Bozek | Behavioral Analyst | 1902 2nd Ave, C/o Crew, Seattle, WA 98101-1155 | 2020-07-14 |
| 1194343483 | Karla Renee Floyd | Behavioral Analyst | 1902 2nd Ave, Seattle, WA 98101-1155 | 2020-07-13 |
| 1336765858 | Stephanie N Light | Counselor | 1902 2nd Ave, Seattle, WA 98101-1155 | 2020-06-20 |
| 1518588730 | Summer Rachelle Lowery Mienk | Registered Nurse | 1902 2nd Ave, Seattle, WA 98101-1155 | 2020-04-28 |
| 1750931812 | Emily Elizabeth Stelnicki | Counselor | 1902 2nd Ave, Seattle, WA 98101-1155 | 2019-09-19 |
| 1609424324 | Raychel Gaines | Counselor | 1902 2nd Ave, Seattle, WA 98101-1155 | 2019-08-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659987485 | David James Sanders | Internal Medicine | 1100 Ninth Avenue: Attention David Sanders, G2-pmr, Seattle, WA 98101 | 2020-09-17 |
| 1295356483 | Yvette Marie Sampson | Peer Specialist | Josephinum C/o Crew, 1902 2nd Ave., Seattle, WA 98101 | 2020-04-29 |
| 1699313353 | Eunyoung Kim | Pharmacist | 925 Seneca Street, H3-pi, Seattle, WA 98101 | 2019-12-12 |
| 1407405657 | Maryanne Wambui Mirie | Registered Nurse | Josephinum 1902 2 Nd Ave, C/o Crew ., Seattle, WA 98101 | 2019-09-10 |
| 1437714854 | Bossakara Sokhom | Student in an Organized Health Care Education/Training Program | 925 Seneca St. Mailstop H8-gme, Seattle, WA 98101 | 2019-05-01 |
| 1841752516 | Hai Quan Ngoc Truong | Student in an Organized Health Care Education/Training Program | 925 Seneca St, H8-gme, Seattle, WA 98101 | 2019-04-02 |
| 1134689318 | Kaitlin Alyse Geck | Student in an Organized Health Care Education/Training Program | 928 Seneca St, Mail Sop: H8-gme, Seattle, WA 98101 | 2019-03-22 |
| 1659860088 | Jaime Mauricio Jimenez | Student in an Organized Health Care Education/Training Program | Virginia Mason 925 Seneca St, Mail Sop: H8-gme, Seattle, WA 98101 | 2018-05-01 |
| 1184156861 | Benjamin Perin | Student in an Organized Health Care Education/Training Program | 925 Seneca Street, H8-gme, Virginia Mason, Seattle, WA 98101 | 2017-03-31 |
| 1316478258 | John Robert Coleman | Anesthesiology | 1100 9th Ave Ms: M4-pfs, Seattle, WA 98101 | 2017-03-22 |
| Find all providers in zip 98101 | ||||
| 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 |
|---|---|---|---|---|
| 1013523737 | Christine Siebels-lindquist | Case Manager/Care Coordinator | 4039 9th Ave Ne, Seattle, WA 98105-6476 | 2020-09-17 |
| 1114549029 | Kathryn Larimore | Case Manager/Care Coordinator | 2100 24th Ave S Ste 250, Seattle, WA 98144-4644 | 2020-05-13 |
| 1205469152 | Davis Haywood | Case Manager/Care Coordinator | 325 9th Ave # 359607, Seattle, WA 98104-2420 | 2020-02-19 |
| 1932753241 | Marlene Rebecca Carricaburu | Case Manager/Care Coordinator | 325 9th Ave # 359859, Seattle, WA 98104-2499 | 2019-07-25 |
| 1518528173 | Michael Humphrey | Case Manager/Care Coordinator | 1119 E Fir St, Seattle, WA 98122-5415 | 2019-06-25 |
| 1801359377 | Maluofiti Valentino Le'iato | Case Manager/Care Coordinator | 12037 1st Ave S Apt B205, Seattle, WA 98168-5035 | 2019-04-10 |
| 1780156992 | Michelle Nayoung Kim | Case Manager/Care Coordinator | 1618 S Lane St, Seattle, WA 98144-2829 | 2018-12-28 |
| 1487125407 | Erin David Tate | Case Manager/Care Coordinator | 5444 Delridge Way Sw, Seattle, WA 98106-1534 | 2018-12-17 |
| 1710452362 | Carrie Jambresic | Case Manager/Care Coordinator | 5126 47th Ave Ne, Seattle, WA 98105-2925 | 2018-10-10 |
| 1063996601 | Laura Nagel | Case Manager/Care Coordinator | 2131 N 113th St Apt 3, Seattle, WA 98133-7644 | 2018-09-19 |
| Find all providers in SEATTLE | ||||
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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.