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JORDAN DAVID COUCEYRO
NPI 1053071027
Student in an Organized Health Care Education/Training Program in Atlanta, GA

Active since December 17, 2021PECOS Enrolled
100 WOODRUFF CIR NE, ATLANTA, GA 30322(404) 727-5655 Get Directions Write a Review

NPPES record last updated: December 17, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jordan David Couceyro NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JORDAN DAVID COUCEYRO (NPI 1053071027) is an individual student in an organized health care education/training program in Atlanta, Georgia and active in the NPI registry since December 2021. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1053071027
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameJORDAN DAVID COUCEYRO
Location Address100 WOODRUFF CIR NEAtlanta, GA 30322-1020
Mailing Address100 Woodruff Cir NeAtlanta, GA 30322-1020
Phone(404) 727-5655
Sole ProprietorNo
Enumeration DateDecember 17, 2021
NPPES CertifiedDecember 17, 2021
✔ NPI 1053071027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
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.
100 WOODRUFF CIR NE, Atlanta, GA 30322
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan David Couceyro is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

QSANET TEKIE
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5655
JOSHUA HYUNKEE KIM
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5655
PATRICIA ELIZABETH CHAN
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5910
KAMSIYONNA ADICHIE
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5655
BENNETT BOUSHKA
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5660
SOPHIE BLASBERG
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5660
DESTINY EKWUEME
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5660
ANDEE KOO
Student in an Organized Health Care Education/Training Program
100 WOODRUFF CIR NE
ATLANTA, GA 30322
Dekalb County (404) 727-5640

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Couceyro's NPI number?

The NPI number for Jordan Couceyro is 1053071027. It was assigned to this individual provider in the NPPES registry on December 17, 2021.

Where is Jordan Couceyro located?

Jordan Couceyro practices at 100 Woodruff Cir NE, Atlanta, GA 30322. The listed phone number is (404) 727-5655.

What is Jordan Couceyro's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jordan Couceyro enrolled in Medicare?

Yes. Jordan Couceyro is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jordan Couceyro was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.