DR. MARK K JORDAN (NPI# 1922002252) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922002252 |
| Entity Type | Individual |
| Full Name | DR. MARK K JORDAN |
| Credential | M.D. |
| Practice Address |
900 Medical Village Dr Edgewood KY 41017 |
| Mailing Address |
Po Box 635283 Cincinnati OH 45263-5283 |
| Practice Telephone | 8593310774 |
| Practice Fax Number | 8595783800 |
| Mailing Telephone | 8593310774 |
| Mailing Fax Number | 8595783800 |
| Enumeration Date | 2005-05-23 |
| Last Update Date | 2018-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
01071044A | IN | Allopathic & Osteopathic Physicians |
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
38774 | KY | Allopathic & Osteopathic Physicians |
| N | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
01071044A | IN | Allopathic & Osteopathic Physicians |
| Y | 207RI0011X |
Internal Medicine Specialization: Interventional Cardiology |
38774 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | 2528572 | 05 | |
| KY | 64083108 | 05 | |
| IN | 200501330 | 05 | |
| KY | RAILROAD MEDICARE | P00920128 | 01 |
| KY | 50024715 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760938310 | Mark Jordan | Pharmacist | 5719 Us 23, Oscoda, MI 48750 | 2016-09-01 |
| 1326459892 | Mark Jordan | Case Manager/Care Coordinator | 300 Hartford Dr, Lancaster, OH 43130-1571 | 2014-05-18 |
| 1568801025 | Mark Allen Jordan | Orthopaedic Surgery | 9600 Gross Point Rd Ste 2900, Skokie, IL 60076-1214 | 2013-06-18 |
| 1881772309 | Mark Vernon Jordan | Internal Medicine | 12801 W Wyndridge Ct Apt 203, New Berlin, WI 53151-8799 | 2006-11-01 |
| 1013478338 | Mark Austin Jordan | Behavior Technician | 29174 Sw Town Center Loop W Ste 101, Wilsonville, OR 97070-9309 | 2019-03-28 |
| 1619212966 | Mark Franklin Jordan | Dentist | 6120 Paseo Del Norte, K1, Carlsbad, CA 92011-1150 | 2012-11-27 |
| 1063748085 | Mark Jordan | Pharmacist | 2400 S Avenue A, Yrmc Pharmacy Department, Yuma, AZ 85364-7127 | 2009-10-27 |
| 1740374461 | Mark Jordan | Psychologist | 2701 W 68th Street, Chicago, IL 60629 | 2006-10-03 |
| 1902901937 | Mark Saunders Jordan | Specialist | 117 E Kings Hwy, Eden, NC 27288-5201 | 2006-09-14 |
| 1831121607 | Mark Louis Jordan | Urology | 90 Bergen St, Doc 2300, Newark, NJ 07103-2425 | 2006-07-06 |
| Street Address |
900 MEDICAL VILLAGE DR |
| City | EDGEWOOD |
| State | KY |
| Zip Code | 41017 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275536302 | Jerome B Schutzman | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017 | 2005-05-23 |
| 1083212344 | Kelly O'brien | Physician Assistant | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2020-10-09 |
| 1841814423 | Patrick Howard Counts | Student in an Organized Health Care Education/Training Program | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2020-05-30 |
| 1316341597 | April Sawyers | Nurse Practitioner | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2014-10-16 |
| 1407121601 | Stephen Joseph Schutzman | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2012-03-20 |
| 1346515988 | Christina Staggs | Nurse Practitioner | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2012-03-15 |
| 1265642193 | Saadeddine Dughman | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017 | 2007-05-22 |
| 1861440984 | Carmen S. Grandt | Physician Assistant | 900 Medical Village Dr, Edgewood, KY 41017 | 2006-05-04 |
| 1417934415 | Cardiology Associates, Psc | Internal Medicine | 900 Medical Village Dr, Edgewood, KY 41017-3422 | 2005-12-30 |
| 1104821982 | Marla Smith Johnson | Nurse Practitioner | 900 Medical Village Dr, Medi, Edgewood, KY 41017 | 2005-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578187209 | St. Elizabeth Medical Center, Inc. | Pharmacy | 1 Medical Village Dr., Edgewood, KY 41017 | 2020-05-28 |
| 1366084337 | St. Elizabeth Medical Center, Inc. | Pharmacy | 850 Thomas More Parkway, Edgewood, KY 41017 | 2019-10-11 |
| 1396396750 | Family First Vision Care Kentucky | Optometrist | 614 Buttermilk Pike, Fort Mitchell, KY 41017 | 2019-09-26 |
| 1083184543 | Katie Franconia Smith | Nurse Practitioner | 2865 Chancellor Dr., Crestview Hills, KY 41017 | 2018-11-27 |
| 1871077511 | Janet Reeves Martin | Nurse Practitioner | Infinity Dialysis, 4750 East Galbraith Rd. Suite 103, Cincinnati, OH 41017 | 2018-09-19 |
| 1144713983 | Kelly Wiechart | Dentist | 599 Freedom Park Dr Ste 100, Crestview Hills, KY 41017 | 2018-06-06 |
| 1225535966 | Proscan Radiology Northern Kentucky, LLC | Radiology | 350 Thomas More Pkwy Ste 170, Crestview Hills, KY 41017 | 2018-04-10 |
| 1396241626 | Tressa S. Leahy | Physical Therapist | 200 Medical Village Drive, Edgewood, KY 41017 | 2018-04-04 |
| 1699294470 | Raymond Gardinier | Physical Therapist | 3755 Old Ky 17, Fort Wright, KY 41017 | 2017-09-13 |
| 1992229785 | Adrienne Bussard | Physician Assistant | 334 Thomas More Pkwy Ste 120, Crestview Hills, KY 41017 | 2017-08-02 |
| Find all providers in zip 41017 | ||||
| Taxonomy Code | 207RI0011X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Interventional Cardiology |
| An area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/ Board Certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. ACGME Accredited Residency Program Requirements: 1 year of training plus a prerequisite of 3 years Internal Medicine, 3 years Cardiovascular Disease for a total of 7 years. ABMS Approved Subspecialty Certificate (Internal Medicine) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093250615 | Advanced Vascular Institute | Internal Medicine | 1374 Highway 192 E, London, KY 40741-3123 | 2017-01-05 |
| 1659770733 | Scott C Harris Do Pllc | Internal Medicine | 112 Windmere Dr, Bowling Green, KY 42103-8720 | 2014-08-14 |
| 1457554750 | Tullio Emanuele Md, Psc | Internal Medicine | 720 Second Street, Suite 204, Bowling Green, KY 42101-5852 | 2007-06-06 |
| 1083823421 | Our Lady of Bellefonte Hospital | Internal Medicine | 1180 Saint Christopher Dr, Ste. 2, Ashland, KY 41101-7055 | 2007-05-22 |
| 1750359857 | Michele A Friday | Internal Medicine | 1180 Saint Christopher Dr Ste 2, Ashland, KY 41101-7055 | 2006-03-14 |
| 1740255314 | Avichai Eres | Internal Medicine | 161 N Eagle Creek Dr, Suite 400, Lexington, KY 40509-9038 | 2006-02-17 |
| 1053310409 | Mohammed Kazimuddin | Internal Medicine | 825 Second Ave, Ste B1, Bowling Green, KY 42101 | 2005-07-19 |
| 1235645607 | Appalachian Vascular Institute, Pllc | Internal Medicine | 243 Roy Campbell Dr Ste B, Hazard, KY 41701-9485 | 2017-12-21 |
| 1770001877 | Owensboro Health Medical Group, Inc. | Internal Medicine | 2025 W Everly Brothers Blvd, Powderly, KY 42367-5401 | 2017-09-08 |
| 1346788023 | Julie Reinstatler | Internal Medicine | 800 Rose St, Lexington, KY 40536-7001 | 2017-02-02 |
| 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.