MR. KENNETH MICHAEL JORDAN (NPI# 1801935044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1801935044 |
| Entity Type | Individual |
| Full Name | MR. KENNETH MICHAEL JORDAN |
| Credential | OWNER |
| Practice Address |
4201 E Loop 820 S Ste C Ft Worth TX 76119-4443 |
| Mailing Address |
Po Box 173248 Arlington TX 76003-3248 |
| Practice Telephone | 8175070185 |
| Practice Fax Number | 8175072190 |
| Mailing Telephone | 8175070185 |
| Mailing Fax Number | 8175072190 |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 2471C3402X |
Radiologic Technologist Specialization: Radiography |
0304041589 | TX | Technologists, Technicians & Other Technical Service Providers |
| X | 2471S1302X |
Radiologic Technologist Specialization: Sonography |
TX | Technologists, Technicians & Other Technical Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710081708 | Kenneth N Jordan | Family Medicine | 520 West Madison Street, Madison Street Clinic PC, Pontiac, IL 61764 | 2006-09-11 |
| 1235186438 | Kenneth A Jordan | Internal Medicine | 295 Maple St Ste 202, Tawas City, MI 48763-9352 | 2006-05-31 |
| 1902867252 | Kenneth Wesley Jordan | Chiropractor | 705 North Fraser St, Georgetown, SC 29442-0958 | 2006-03-28 |
| 1477537116 | Kenneth George Jordan | Specialist | 1660 Plum Ln, Redlands, CA 92374-4532 | 2005-12-06 |
| 1366049900 | Kenneth Bernard Jordan | Psychiatry & Neurology | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2020-10-06 |
| 1285278580 | Kenneth Warren Jordan | Speech-Language Pathologist | 2600 Compass Rd, Glenview, IL 60026-8001 | 2019-10-30 |
| 1548739147 | Kenneth Jordan | Counselor | 1700 Airport Way S, Seattle, WA 98134-1618 | 2018-11-13 |
| 1386122141 | Kenneth Jordan | Social Worker | 29 Maple St, Littleton, NH 03561 | 2018-08-03 |
| 1932440385 | Kenneth W Jordan | Pharmacist | 701 E Milam St, Mexia, TX 76667-2445 | 2013-03-11 |
| 1184628505 | Kenneth Wayne Jordan | Pediatrics | 2100 Erwin Rd, Durham, NC 27705-3941 | 2005-06-13 |
| Street Address |
4201 E LOOP 820 S STE C |
| City | FT WORTH |
| State | TX |
| Zip Code | 76119-4443 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467003111 | Asha Jamilia Robertson | Technician | 5321 Rita Kay Ln Lot #21, Fort Worth, TX 76119 | 2019-09-24 |
| 1801366406 | Gina Stovall | Behavioral Analyst | 1100 Circle Drive Suite 101, Fort Worth, TX 76119 | 2018-11-27 |
| 1730660374 | Lisa Alfaro Williams | Counselor | 3120, 22, 24 S.e. Loop 820, Fort Worth, TX 76119 | 2018-08-22 |
| 1023597366 | Gregoire M Butera | Registered Nurse | 3883 Mighty Mite Dr., Fort Worth, TX 76119 | 2018-08-08 |
| 1598244816 | Tawnya R Anderson | Registered Nurse | 3883 Mighty Mite Drive, Fort Worth, TX 76119 | 2018-08-08 |
| 1730699802 | Miller Dental Pllc | Dentist | 3307 Miller Ave Suite #a, Fort Worth, TX 76119 | 2017-10-03 |
| 1053853697 | Carla Walter | Community Health Worker | 4125 Hardeman Ave, Fort Worth, TX 76119 | 2016-11-14 |
| 1710238134 | Thuy Vy Phan | Physician Assistant | 2500 Circle Dr, Fort Worth, TX 76119 | 2012-09-25 |
| 1598031841 | Candace Frances Been | Podiatrist | Federal Bureau of Prisons Federal Medical Center Fort, 3150 Horton Road, Fort Worth, TX 76119 | 2012-03-30 |
| 1053600262 | Miller Dental | Dentist | 3307 Miller Ave Suite A, Fort Worth, TX 76119 | 2011-03-29 |
| Find all providers in zip 76119 | ||||
| Taxonomy Code | 2471C3402X |
| Grouping | Technologists, Technicians & Other Technical Service Providers |
| Classification | Radiologic Technologist |
| Specialization | Radiography |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144842980 | Brandi Bentley | Radiologic Technologist | 10605 Camillia Blossom Ln, Austin, TX 78748-3009 | 2020-05-14 |
| 1013480961 | Eclipse Massage Therapy | Radiologic Technologist | 4321 Center St., Deer Park, TX 77536 | 2019-01-03 |
| 1013484286 | Anissa Dusenberry | Radiologic Technologist | 8702 17th St, Lubbock, TX 79416-1930 | 2018-10-25 |
| 1538529946 | Christopher Smith | Radiologic Technologist | 3600 W Loop 250 N Apt 1059, Midland, TX 79707-3437 | 2016-02-26 |
| 1417222159 | Gina Bernal | Radiologic Technologist | 1022 Huey, Corpus Christi, TX 78418-1606 | 2012-03-13 |
| 1336476514 | Trey Colin Petty | Radiologic Technologist | 4508 37th St, Lubbock, TX 79414-2615 | 2009-11-10 |
| 1609031897 | Julio Morales Maldonado | Radiologic Technologist | 2403 Naomi St, Unit 12, Houston, TX 77054-4022 | 2008-07-28 |
| 1972763662 | Sergio Garcia | Radiologic Technologist | 618 W 12th St, Weslaco, TX 78596-7408 | 2008-06-16 |
| 1942460985 | Vanessa Kay Magness | Radiologic Technologist | 774 Airway Ave, Tyler, TX 75704-7806 | 2008-06-12 |
| 1598959355 | Kanu Kanu Nwankwo | Radiologic Technologist | 11311 Bayou Place Ln, Houston, TX 77099-4243 | 2007-09-04 |
| Find all providers with the same taxonomy | ||||
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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.