TODD MICHEAL JORDAN (NPI# 1316495302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316495302 |
| Entity Type | Individual |
| Full Name | TODD MICHEAL JORDAN |
| Credential | LBA, LPC |
| Practice Address |
2451 Fair St Poplar Bluff MO 63901-7019 |
| Practice Telephone | 5734294810 |
| Mailing Telephone | (573) 429-4810 |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
2014028525 | Behavioral Health & Social Service Providers | |
| N | 103K00000X | Behavioral Analyst | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 S Main St, Poplar Bluff, MO 639015843 | 5736865090 | 5737854104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508081563 | Todd Sims Jordan | Dentist | 921 Main St, North Wilkesboro, NC 28659-4215 | 2007-04-16 |
| 1386610202 | Todd Jordan | Emergency Medicine | 743 Spring St Ne, Gainesville, GA 30501-3715 | 2006-02-28 |
| Street Address |
2451 FAIR ST |
| City | POPLAR BLUFF |
| State | MO |
| Zip Code | 63901-7019 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076701 | Alternative Sleep Solution | Dentist | 2700 Kanell Blvd., Poplar Bluff, MO 63901 | 2020-09-04 |
| 1285271239 | Front Door Wellness LLC | Physical Therapist | Front Door Wellness LLC, 5835 Quail Meadows Drive, Poplar Bluff, MO 63901 | 2019-12-09 |
| 1104470368 | Andrew Akindutire | Dentist | 3101 Oak Groove Rd., Suite 6, Poplar Bluff, MO 63901 | 2019-07-26 |
| 1780195966 | Midwest Equipment Srv Systems LLC | Technician, Pathology | 2400 Lucy Lee Parkway, Suite C, Poplar Bluff, MO 63901 | 2017-10-16 |
| 1801259387 | Richard Justin Huber | Technician, Other | 3005 Warrior Ln, Poplar Bluff, MO 63901 | 2016-04-01 |
| 1699136275 | Donja Kirkland | Recreation Therapist | 1910a Greenwood Dr., Suite D, Poplar Bluff, MO 63901 | 2016-03-10 |
| 1760866867 | Bio-medical Applications of Missouri, Inc. | Clinic/Center | 3050 Tucker Road, Poplar Bluff, MO 63901 | 2015-07-17 |
| 1407246390 | Lisa Marie Payne | Physical Therapist | 4358c Highway Pp, Poplar Bluff, MO 63901 | 2015-01-29 |
| 1700202488 | Missouri Dental Professionals, Richard Straus, Dmd, PC | Dentist | 1602 W. Harper Street, Poplar Bluff, MO 63901 | 2014-03-05 |
| 1932521648 | Essential Family Healthcare, LLC | Clinic/Center | 1369 North Westwood Blvd., Poplar Bluff, MO 63901 | 2014-01-15 |
| Find all providers in zip 63901 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205138260 | Andrea L Crafton | Counselor | 4809 West Blvd, Poplar Bluff, MO 63901-8939 | 2010-11-24 |
| 1376795351 | Gina L Duckett | Counselor | 3816 Highway 67 N, Poplar Bluff, MO 63901-8779 | 2008-10-21 |
| 1295987667 | Regina Elizabeth Williams | Counselor | 375 Hibiscus Ln, Poplar Bluff, MO 63901-6932 | 2008-10-16 |
| 1548412349 | Cheryl Lynne Terrell | Counselor | 1425 Camp Rd, Poplar Bluff, MO 63901-3064 | 2008-10-13 |
| 1679761407 | Dale Howard Robinson Sr. | Counselor | 1901 N Westwood Blvd, Ste 8, Poplar Bluff, MO 63901-2800 | 2007-10-05 |
| 1356533053 | Judith Lynne Moss | Counselor | 2725 N Westwood Blvd Ste 8, Poplar Bluff, MO 63901-2367 | 2007-08-16 |
| 1679780019 | Ann C Kneibert | Counselor | 891 Mockingbird Ln, Poplar Bluff, MO 63901-4769 | 2007-05-16 |
| 1083638506 | Robin Denise Vickery | Counselor | 3001 Warrior Ln, Poplar Bluff, MO 63901-8685 | 2006-07-27 |
| 1275531741 | Anna Michaele Wilson | Counselor | 1140 Herschell Bess Blvd, Poplar Bluff, MO 63901 | 2005-07-08 |
| 1508321837 | Royce D Bishop | Counselor | 225 Physicians Park Ste 303, Poplar Bluff, MO 63901-3930 | 2019-01-31 |
| Find all providers in POPLAR BLUFF | ||||
| City | POPLAR BLUFF |
| Zip Code | 63901 |
Please comment or provide details below to improve the information on TODD MICHEAL JORDAN.
| 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.