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JORDAN KAYE OLIPHANT MD
NPI 1164219804
Student in an Organized Health Care Education/Training Program in Saint Cloud, MN

Active since April 24, 2025PECOS Enrolled
1555 NORTHWAY DR STE 200, SAINT CLOUD, MN 56303(320) 240-3157 Get Directions Write a Review

NPPES record last updated: April 24, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jordan Kaye Oliphant Md NPPES

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

JORDAN KAYE OLIPHANT MD (NPI 1164219804) is an individual student in an organized health care education/training program in Saint Cloud, Minnesota and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1164219804
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJORDAN KAYE OLIPHANTCredential: MD
Location Address1555 NORTHWAY DR STE 200Saint Cloud, MN 56303-4913
Mailing Address1555 Northway Dr Ste 200Saint Cloud, MN 56303-4913
Phone(320) 240-3157
Sole ProprietorNo
Enumeration DateApril 24, 2025
NPPES CertifiedApril 24, 2025
✔ NPI 1164219804 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.
1555 NORTHWAY DR STE 200, Saint Cloud, MN 56303
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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 Kaye Oliphant Md 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.

SARA TAROKH MD
Student in an Organized Health Care Education/Training Program
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3112
FARIHA FURQAN QURESHI MD
Family Medicine
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3157
SADIO AHMED MOHAMED MD
Family Medicine
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3157
BASMA ALI KHAN
Student in an Organized Health Care Education/Training Program
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3157
JENNIFER ANN TARPENNING MD
Family Medicine
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3157
DUSTYN JON LEFF
Student in an Organized Health Care Education/Training Program
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3112
DR. BASHIR MOALLIN MBBS
Family Medicine
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3157
JACQUELYN JOSIE ANDERSON DO
Student in an Organized Health Care Education/Training Program
1555 NORTHWAY DR STE 200
SAINT CLOUD, MN 56303
Stearns County (320) 240-3157

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 Oliphant's NPI number?

The NPI number for Jordan Oliphant is 1164219804. It was assigned to this individual provider in the NPPES registry on April 24, 2025.

Where is Jordan Oliphant located?

Jordan Oliphant practices at 1555 Northway Dr Ste 200, Saint Cloud, MN 56303. The listed phone number is (320) 240-3157.

What is Jordan Oliphant'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 Oliphant enrolled in Medicare?

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

When was this NPI record last updated?

The NPPES record for Jordan Oliphant was last updated on April 24, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.