1. Home
  2. Directory
  3. North Carolina
  4. Durham
  5. Pediatrics
  6. NPI Profile

KENNETH WAYNE JORDAN MD
NPI 1184628505
Pediatrics in Durham, NC

Active since June 13, 2005PECOS Enrolled
2100 ERWIN RD, DURHAM, NC 27705(919) 684-8111 Get Directions Write a Review

NPPES record last updated: September 1, 2009. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kenneth Wayne Jordan Md NPPES

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

KENNETH WAYNE JORDAN MD (NPI 1184628505) is an individual pediatrics provider in Durham, North Carolina, licensed in North Carolina (33260) and active in the NPI registry since June 2005. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1184628505
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameKENNETH WAYNE JORDANCredential: MD
Location Address2100 ERWIN RDDurham, NC 27705-3941
Mailing Address2100 Erwin RdDurham, NC 27705-3941 · (919) 684-8111
Phone(919) 684-8111
Sole ProprietorNo
Enumeration DateJune 13, 2005
Last NPPES UpdateSeptember 1, 2009
✔ NPI 1184628505 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in NC · 33260
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2100 ERWIN RD, Durham, NC 27705
Open in Google Maps ↗

Other Identifiers 3

MedicaidBJ1675531NC
Medicare UPINE39829
Medicaid8947445NC

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kenneth Wayne Jordan 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.

Medicare Billing Reassignment

Medicare enrollment records show Kenneth Jordan reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Bladen Healthcare, LLC
94 mi
Rural Health
16 3RD ST
Dublin, NC 28332
  • Reassigned Medicare billing, North Carolina enrollment
  • 170 clinicians in this Medicare group
NPI 1114193695 (910) 862-3528

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 27705 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.90 typical visit price
range $54.12 – $165.09
Typical copayment $20.97 (range $13.53 – $41.27)
Most-billed visit code 99203
Established Patient
$95.94 typical visit price
range $17.21 – $134.61
Typical copayment $23.98 (range $4.30 – $33.65)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. ERIN LIN MANNING MD
Anesthesiology
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
LAURA SVETKEY M.D.
Internal Medicine (Nephrology)
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 620-4467
DR. MARISA D'SILVA M.D.
Internal Medicine
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
DR. AARON SANDLER M.D., PH.D.
Anesthesiology
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
DR. LANCE A. ROY M.D.
Anesthesiology
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
DR. VIJAYA KUMAR KONDA REDDY MD
Pediatrics (Neonatal-Perinatal Medicine)
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111
JENNIFER NEIFELD CAPPS CRNA
Nurse Anesthetist, Certified Registered
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-3595
DR. RICHARD L. BOORTZ-MARX MD
Anesthesiology (Pain Medicine)
2100 ERWIN RD
DURHAM, NC 27705
Durham County (919) 684-8111

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 Kenneth Jordan's NPI number?

The NPI number for Kenneth Jordan is 1184628505. It was assigned to this individual provider in the NPPES registry on June 13, 2005.

Where is Kenneth Jordan located?

Kenneth Jordan practices at 2100 Erwin Rd, Durham, NC 27705. The listed phone number is (919) 684-8111.

What is Kenneth Jordan's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kenneth Jordan enrolled in Medicare?

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

Which organization bills Medicare for Kenneth Jordan's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kenneth Jordan reassigns Medicare benefits to Bladen Healthcare, LLC (Dublin, NC). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kenneth Jordan's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kenneth Jordan was last updated on September 1, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.